Brandon Wayne Divan, DPT, PT
NPI 1790332807ActiveIndividual· Physical Therapist· Belton, MO
Physical Therapist (DPT, PT) in Belton, Missouri, licensed in MO and IL, with an NPI issued in August 2019.
Overview
| NPI | 1790332807 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT, PT |
| Sole proprietor | No |
| NPI issued | Aug 22, 2019 |
| Last updated in NPPES | Oct 6, 2022 |
| Certified by provider | Oct 6, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2022039968 | MO |
| Physical Therapist | 225100000X | 070.024617 | IL |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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