Logan Wallace

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1188 N Salem Rd Ste 1
Fayetteville, AR 72704-8803

Phone

(479) 595-0474

Fax

(479) 239-5444

NPI assigned

Dec 5, 2022

Last updated

Feb 2, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, AR2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rise Physical Therapy IncGroup PAC ID 9133400203, 35 clinicians

Trilogy Physical Therapy, PLLCGroup PAC ID 5294139838, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rise Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Fayetteville, AR
  • NPI 1851743009

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Trilogy Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Ames, IA
  • NPI 1043883564

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rise Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Fayetteville, AR
  • NPI 1104319433
  NPD
• McFarland Clinic, PC

  • Eyewear Supplier
  • Boone, IA
  • NPI 1528149457
  NPD (past)

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1720798325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 E CITIZENS DR STE 5",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034796",
            "telephone_number": "479-442-7473",
            "fax_number": "479-239-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 N SALEM RD STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727048803",
            "telephone_number": "479-595-0474",
            "fax_number": "479-239-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Earl Wall Jr., PA-C
• Angelika Marjorie Wallace
• Bianca Nichole Wallace
• Carla R Wallace, LCSW
• Dan L Wallace, LPC
• Mykala R Wallace, LMSW
• Natalie Wallace
• Sadie Wallace
• Sam Loc Wallace, L.P.C.
• Sarah M Wallace, MHPP

• Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.