Active NPI
Kaelee Wallace, PT, DPT
- Orthopedic Physical Therapist
- Maumelle, AR
National Provider Identifier
1386569820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 223 Country Club Pkwy
Maumelle, AR 72113-6731 - Phone
- (501) 301-4530
- NPI assigned
- Aug 12, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | AR | Primary |
Addresses
Primary practice location
223 Country Club Pkwy
Maumelle, AR 72113-6731
Mailing address
1009 Highway 36
Mount Vernon, AR 72111-9668
Phone (501) 301-4530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Institute | Orthopedic | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1386569820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 HIGHWAY 36",
"city": "MOUNT VERNON",
"state": "AR",
"postal_code": "721119668",
"telephone_number": "501-301-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 COUNTRY CLUB PKWY",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "721136731",
"telephone_number": "501-301-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "KAELEE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-12",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumelle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.