Timi Wallace, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL89428 Issued in MA

Practice address

30 Brigham St
New Bedford, MA 02740-2206

Phone

(774) 770-4903

NPI assigned

Aug 14, 2026

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)

Not enrolled

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

{
    "created_epoch": "1786665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1235044488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KLONDIKE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029095517",
            "telephone_number": "401-390-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BRIGHAM ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027402206",
            "telephone_number": "774-770-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TIMI",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-14",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL89428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Amanda Lee Walker, MSW, PHD
• Lauren Walker
• Allison Jessie Wallace, RBT
• Jennifer Jane Wallace, PA
• Maureen Elizabeth Walsh I, MA
• Stanley Walsh Jr., D.D.S.
• Meghan Wanderer, N.P.
• Ying Wang, NURSE PRACTITIONER
• Sareem Wani, M.B., B.S.

• All providers in New Bedford, MA
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.