Independent Physical Therapy of Ga LLC
NPI 1699264267ActiveOrganization· Physical Therapist· Ellenwood, GA
Physical Therapist in Ellenwood, Georgia, registered in NPPES in May 2018. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle.
Overview
| NPI | 1699264267 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 9, 2018 |
| Last updated in NPPES | May 9, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other physical therapists in Ellenwood
- 1073832598
- 1487201638
- 1780460279
- 1790908572
- 1881174829
- 1922353192
- 1417071564
- 1487269619
- 1639727944
- 1689460073
- 1689465767
- 1831329663
All 18 physical therapists in Ellenwood · All physical therapists in Georgia