Tyler Wallis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303263 Issued in CA

Practice address

801 Sterling Pkwy Ste 150
Lincoln, CA 95648-7328

Phone

(916) 543-7900

NPI assigned

Nov 16, 2022

Sex

Male

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

State licenses

Practice roles

Locations

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.

• Swanson Schaack Physical Therapy

  • Physical Therapist
  • Lincoln, CA
  • NPI 1316083041
  NPD
• Folsom Physical Therapy & Training Center Inc

  • Physical Therapy Clinic/Center
  • Folsom, CA
  • NPI 1376379248

  Physical Therapist

  NPD (past)
• Folsom Physical Therapy and Training Center

  • Orthopedic Physical Therapist
  • Folsom, CA
  • NPI 1497788202
  NPD (past)

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1184333494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 E BIDWELL ST STE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303897",
            "telephone_number": "916-853-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 STERLING PKWY STE 150",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487328",
            "telephone_number": "916-543-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violet Holdings, LLC (Lincoln Meadows Care Center)
• Jackquelyn Paige Virgil
• Vituity - Urgent Care Services PC
• Namthuyen T Vu, D.M.D.
• Walgreen Co (Walgreens #12525)
• Walmart Inc. (WalMart Pharmacy 10-5979)
• April L Ward, NP
• Garth Reed Ward, M.A., LEP, ABSNP
• Zabihullah Shirzoi Wardak, M.D.
• Ali Watford, MS

• Physical Therapist in Lincoln, CA
• Providers in Lincoln, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.