Daelene Sueann Tibbitts, PTA
NPI 1891247912ActiveIndividual· Physical Therapy Assistant· Mountain Home, ID
Physical Therapy Assistant (PTA) in Mountain Home, Idaho, licensed in ID, with an NPI issued in October 2016.
Overview
| NPI | 1891247912 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | Yes |
| NPI issued | Oct 25, 2016 |
| Last updated in NPPES | Oct 25, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | PTA-4637 | ID |
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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