Mackenzie Wall, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21317 Issued in NC

Practice address

138 Magnolia Dr
Smithfield, NC 27577-4758

Phone

(919) 989-6594

Fax

(919) 989-6532

NPI assigned

Jun 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mackenzie Johnson Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Advanced Physical Therapy Solutions LLC

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1467405019

  NC, Physical Therapist

  Medicare reassignment NPD
• Quality Therapy Services Inc

  • Physical Therapist
  • Smithfield, NC
  • NPI 1285778779
  NPD (past)
• Quality Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Smithfield, NC
  • NPI 1598092884
  NPD (past)

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1194454058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MAGNOLIA DR",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774758",
            "telephone_number": "919-989-6594",
            "fax_number": "919-989-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MAGNOLIA DR",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774758",
            "telephone_number": "919-989-6594",
            "fax_number": "919-989-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MACKENZIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Diana Walker, PA-C
• Michele Walker, LCMHC
• Taylor Ryan Washburn, LMBT 14448
• Jaclyn Wassel
• Kristen Golding Waters, MS, CCC-SLP
• Renee G Watson, MD
• Shannon Watson

• All providers in Smithfield, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.