Tangela Wallace, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26730 Issued in FL

Practice address

3101 Ginger Dr
Tallahassee, FL 32308-4437

Phone

(850) 877-2177

NPI assigned

May 10, 2016

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1245686013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 GINGER DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084437",
            "telephone_number": "850-877-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 GINGER DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084437",
            "telephone_number": "850-877-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TANGELA",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26730",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA001884",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1245686013",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Wallace Chatfield, LCSW
• Alexandra Wallace
• Angela Suzanne Wallace, OTD, M.ED., OTR/L
• Jay William Wallace, PHARM. D.
• Mervin P Wallace, MD
• Kayla Renae Waller, FNP-C
• Wesley Waller
• Marshall David Walls, ATC
• Mary J. Walsh, M.S., CCC-SLP
• Michelle Walsh, LCSW

• Physical Therapy Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.