Pro Impact Physical Therapy and Sports Performance, LLC
NPI 1780813618ActiveOrganization· Physical Therapist· Montgomery, AL
Physical Therapist in Montgomery, Alabama, registered in NPPES in July 2009. The authorized official on file is Charles Michael Ellis, P.T., ATC, Physical Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1780813618 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 13, 2009 |
| Last updated in NPPES | Apr 4, 2022 |
| Certified by provider | Apr 4, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PTH1388 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL) |
|---|
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