Lakeside Orthopedic Institute, LLC
NPI 1962636050ActiveOrganization· Physical Therapist· Lake Havasu City, AZ
Physical Therapist in Lake Havasu City, Arizona, registered in NPPES in May 2009. The authorized official on file is Wesley James Johnson, M.D., President.
Overview
| NPI | 1962636050 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 5, 2009 |
| Last updated in NPPES | May 5, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2641 | AZ |
| Physical Therapist | 225100000X | 8192 | AZ |
| Physical Therapist | 225100000X | 6762 | AZ |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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