Ashlyn Wallace

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12701 Issued in SC

Practice address

200 Patewood Dr Ste C250
Greenville, SC 29615-3593

Phone

(864) 780-4793

NPI assigned

Feb 14, 2025

Last updated

Feb 14, 2025By 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 SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 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.

• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment Care Compare group NPD
• Greenville Proaxis Therapy LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1720883838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-780-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ASHLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Keith Walker, D.D.S.
• Wesiona Donyavetta Walker, LMSW
• Elizabeth Jacques Wall, RN
• Susan K Wall, COTA
• Amy Piatt Wallace, MSR,CCC-SLP
• Dantoria Wallace, LPN
• Douglass Michael Wallace, MD
• James E. B. Wallace Jr.
• Lisa Wallace, CNP
• Monte N Wallace, LMSW

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.