Jocelyn Diane Wallace, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Practice address

1830 Radius Dr Apt 910
Hollywood, FL 33020-7716

Phone

(813) 407-9004

NPI assigned

Jul 26, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Wallace Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Hollywood, FL
  • NPI 1407335268
  NPD Authorized official
• Back to Normal Physical Therapy, Inc.

  • Physical Therapist
  • Saint Petersburg, FL
  • NPI 1861932659
  NPD (past)

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1154845600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 RADIUS DR APT 910",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330207716",
            "telephone_number": "813-407-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 RADIUS DR APT 910",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330207716",
            "telephone_number": "813-407-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOCELYN",
        "middle_name": "DIANE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walif Aji MD PA
• Lenore E Walker, PSYCHOLOGIST
• Walkie Talkie Therapy Group, Inc
• Wallace Physical Therapy LLC
• Stephanie Rutledge Wallace, RPH
• Marlene Wallen, ARNP
• Priscilla Walters
• Wilson Christopher Walters, COTA
• Melissa Wandique

• Orthopedic Physical Therapist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.