Pryde Physical Therapy PLLC
NPI 1912503830ActiveOrganization· Physical Therapist· Canton, MI
Physical Therapist in Canton, Michigan, registered in NPPES in December 2020. The authorized official on file is Ivan Ankwatsa, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1912503830 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 7, 2020 |
| Last updated in NPPES | Jul 1, 2026 |
| Certified by provider | Jul 1, 2026 |
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 (MI) |
|---|
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