Ultimate Performance Lab LLC
NPI 1912856725ActiveOrganization· Physical Therapist· Nottingham, MD
Physical Therapist in Nottingham, Maryland, registered in NPPES in January 2026. The authorized official on file is Grant R. Sullivan, PT, DPT, Owner/ Physical Therapist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1912856725 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 26, 2026 |
| Last updated in NPPES | Apr 18, 2026 |
| Certified by provider | Apr 18, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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 - Physical/Occupational Therapy Group in Private Practice (MD) |
|---|
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