Tiffany Dawn Wallace, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT24764 Issued in FL

Practice address

701 Platinum PT
Lake Mary, FL 32746-4871

Phone

(407) 206-4500

Fax

(407) 643-2802

NPI assigned

Jun 29, 2009

Last updated

Apr 12, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

79.91 of 100Reported as group

Quality

61.18

Promoting interoperability

100

Improvement activities

40

Cost

71.86

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1689802662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PLATINUM PT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464871",
            "telephone_number": "407-206-4500",
            "fax_number": "407-643-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PLATINUM PT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464871",
            "telephone_number": "407-206-4500",
            "fax_number": "407-643-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TIFFANY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "24764",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT24764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holleigh Lynette Walker
• Marcela Gallego Walker, PHARMD
• Susan F Walker
• Tori Walker
• Walking Tree Family Practice, Inc
• John Waller
• Pete Wang, DPT
• Jennifer Meriah Ward, CCC-SLP
• Kristen Renee Ward, C.N.M.
• Michael Alan Warner, M.D

• Orthopedic Physical Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.