Southern Ohio Sports Medicine and Physical Therapy
NPI 1700188463ActiveOrganization· Specialist· Peebles, OH
Specialist in Peebles, Ohio, registered in NPPES in November 2010. The authorized official on file is Melissa Mae Waddell, PT, Physical Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1700188463 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 30, 2010 |
| Last updated in NPPES | Nov 30, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | PT 5740 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OH) |
|---|
Other Specialist providers in Peebles
- 1750665295
- 1831346758