Kathleen Wallace, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT294253 Issued in CA

Practice address

85 Hartnell Ave
Redding, CA 96002-1887

Phone

(530) 226-9242

NPI assigned

Oct 3, 2015

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Burch Physical Therapy, Inc.Group PAC ID 2961438569, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.84 of 100Reported as group

Quality

90

Improvement activities

40

Cost

72.05

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Burch Physical Therapy, Inc.

  • Physical Therapist
  • Redding, CA
  • NPI 1447215116
  Medicare reassignment Care Compare group NPD
• Elevate Physical Therapy Inc

  • Physical Therapist
  • Anderson, CA
  • NPI 1114538782
  NPD
• Redding Rancheria

  • Federally Qualified Health Center (FQHC)
  • Redding, CA
  • NPI 1104859354
  NPD (past)

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

{
    "created_epoch": "1443830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1568832426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARTNELL AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021887",
            "telephone_number": "530-226-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HARTNELL AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021887",
            "telephone_number": "530-226-9242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 W Eugie Ave Ste No202",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853041255",
            "country_code": "US",
            "telephone_number": "602-843-8436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 Barney Rd",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "CA",
            "postal_code": "960074337",
            "country_code": "US",
            "telephone_number": "530-365-2142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "KATHLEEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-03",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11042",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT294253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne D Walker
• Amanda Wall
• Matthew Wall, MASSAGE THERAPIST
• Norman Wall, DO
• Heather Marie Wallace
• Mark D Wallace, M.D.
• Nathan Wallace
• Walmart Inc.
• Walmart, Inc.
• Walter L. Fletscher, M.D., Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.