Body Renovation Physical Therapy SC
NPI 1871664243ActiveOrganization· Physical Therapist· Grafton, WI
Physical Therapist in Grafton, Wisconsin, registered in NPPES in November 2006. The authorized official on file is Richard D. Wagner, PT CSCS VCS, Partner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1871664243 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 10, 2006 |
| Last updated in NPPES | Jan 30, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (WI) |
|---|
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