Godiza Marie Wallace

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24366 Issued in MD

Practice address

5425 Wisconsin Ave Ste 600
Chevy Chase, MD 20815-3588

Phone

(866) 525-3175

NPI assigned

Apr 6, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fox Rehab PT MD LLC

  • Physical Therapist
  • Timonium, MD
  • NPI 1588901847
  Medicare reassignment
• Fox Rehabilitation Services LLC

  • Physical Therapist
  • Winchester, VA
  • NPI 1609814755

  DC

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1083556591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 600",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153588",
            "telephone_number": "866-525-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 600",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153588",
            "telephone_number": "866-525-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "GODIZA MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "11665 Doolittle Dr",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206022898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7819 Rocky Springs Rd",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217022824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "9708 Belair Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212361108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "6451 N Charles St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212121010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Leonard Wald, LCSWC
• Sonya Wali, DPM
• Ashley Walker-Smith, APRN
• Robert Edward Walker, MD
• Alicia Jacqueline Wallace
• Ryan McDonald Walley, M.D.
• Ashley Tremblay Walton, PA-C
• Angela Wang
• Judy Wang, LCPC, CPC
• Michael NA Wannon, PH.D.

• Physical Therapist in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.