Lance Austin Wheeler, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16653 Issued in TN

Practice address

1700 W Market St Ste F&G
Bolivar, TN 38008-1653

Phone

(731) 658-2206

Fax

(731) 659-2061

NPI assigned

Dec 6, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Star Physical Therapy LP

  • Rehabilitation Clinic/Center
  • Bolivar, TN
  • NPI 1417404351
  NPD (past)
• Star Physical Therapy LP

  • Physical Therapist
  • Caruthersville, MO
  • NPI 1073375861
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1144735671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590",
            "fax_number": "615-591-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W MARKET ST STE F&G",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081653",
            "telephone_number": "731-658-2206",
            "fax_number": "731-659-2061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1681 Camden Forrest Way",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302962975",
            "country_code": "US",
            "telephone_number": "404-769-1088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 Chapel Hill Rd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351721",
            "country_code": "US",
            "telephone_number": "678-981-6290",
            "fax_number": "678-981-6291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 Peachtree Dunwoody Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303286773",
            "country_code": "US",
            "telephone_number": "770-225-8465 x31006",
            "fax_number": "866-587-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "LANCE",
        "middle_name": "AUSTIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003644",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029723",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP
• George W Walters, Jr, O.D.
• Patricia N Warren
• Kelvin Washington
• Broderick Webster Sr., LPC
• Catherine Ann White, LSW
• Danielle Whitehurst, MD
• Darshanula Wilkes
• Bruce Wilks, LADAC
• Emylee Ann Williams, OTR/L

• Physical Therapist in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.