KELLY WALLACE (NPI# 1760727283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760727283 |
| Entity Type | Individual |
| Full Name | KELLY WALLACE |
| Credential | PT |
| Practice Address |
7160 Tchulahoma Rd Ste 4 Southaven MS 38671-9266 |
| Practice Telephone | 6623492733 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 1734 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124675749 | Kelly Love Wallace | Counselor | 2817 Stonebrook Rd, Edmond, OK 73003-2105 | 2019-08-19 |
| 1841704467 | Kelly M Wallace | Social Worker | 11 Mills Rd, Middletown, NY 10941-1018 | 2017-11-17 |
| 1194892810 | Kelly Wallace | Physical Therapist | 8619 Broadway St Ste 200, Pearland, TX 77584-8496 | 2006-11-29 |
| 1184696023 | Kelly Wallace | Physical Therapist | 13390 Ne 23rd St, Choctaw, OK 73020-8622 | 2006-02-05 |
| 1669464350 | Kelly A Wallace | Nurse Anesthetist, Certified Registered | 615 S New Ballas Rd, Sjmmc Dept of Anes, Saint Louis, MO 63141-8221 | 2005-08-18 |
| Street Address |
7160 TCHULAHOMA RD STE 4 |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770987935 | Kara Cline | Occupational Therapy Assistant | 7160 Tchulahoma Rd Ste 4, Southaven, MS 38671-9266 | 2014-10-17 |
| 1922446814 | Renita Monae Isom | Speech-Language Pathologist | 7160 Tchulahoma Rd Ste 4, Southaven, MS 38671-9266 | 2013-06-12 |
| 1588904015 | Apryl Suzanne Moore | Speech-Language Pathologist | 7160 Tchulahoma Rd Ste 4, Southaven, MS 38671-9266 | 2013-02-20 |
| 1528308178 | Mary Kate Whelan | Speech-Language Pathologist | 7160 Tchulahoma Rd Ste 4, Southaven, MS 38671-9266 | 2013-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
| 1518469063 | Revolution Physical Therapy LLC | Physical Therapist | 3075 Goodman Rd E Suite 7, Southaven, MS 38672-6359 | 2018-03-01 |
| 1093233157 | Zachary Kyle Tate | Physical Therapist | 3964 Goodman Rd E Ste 111, Southaven, MS 38672-8761 | 2017-09-08 |
| 1235650292 | John F. Mangialardi | Physical Therapist | 7065 Airways Blvd Ste 110, Southaven, MS 38671-5874 | 2017-06-29 |
| 1699125153 | Meredith Turner | Physical Therapist | 3334 Marcia Louise Dr, Southaven, MS 38672-6754 | 2016-06-15 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1104263433 | April Michelle Ellis | Physical Therapist | 484 Church Rd E, Southaven, MS 38671-9714 | 2013-05-28 |
| 1932455870 | Kelly Jean Maclain | Physical Therapist | 391 Southcrest Cir Ste 205, Southaven, MS 38671-6729 | 2012-07-30 |
| 1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
| 1538315726 | Roy A. Alinsub | Physical Therapist | 4740 Highway 51 N, 21-101, Southaven, MS 38671-7940 | 2008-08-07 |
| Find all providers in SOUTHAVEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.