Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith Poorbaugh, PT, SCD, OCS, FAAOMP

Individual provider Physical Therapist · NPI 1003971037

Keith Poorbaugh, PT, SCD, OCS, FAAOMP is a Physical Therapist in Private Practice in Wasilla, Alaska. Graduated from Mayo Medical School in 1997, 29 years ago. Practices with Northern Edge Physical Therapy Limited Partnership, a 5-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
29
Trained at
Mayo Medical School
Licensed in
AK
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

984 N Meridian Pl # A
Wasilla, AK 99654-7215
Phone: (907) 631-4029
Fax: (907) 631-4128
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1581 (AK)

Record details

NPI number1003971037
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , SCD , OCS , FAAOMP
Sole proprietorNo
NPI enumeratedDecember 27, 2006
Last updated in NPPESJuly 21, 2022
Certification dateApril 7, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolMAYO MEDICAL SCHOOL
Graduated 1997 (29 years in practice)
Group practice Northern Edge Physical Therapy Limited Partnership — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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