Trevor A Wallace, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13354 Issued in TN

Practice address

1819 Clinch Ave Ste 106
Knoxville, TN 37916-2435

Phone

(865) 633-0259

Fax

(865) 524-5047

NPI assigned

Jun 3, 2021

Sex

Male

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 TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Tennessee, HSC, College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tennessee Orthopaedic Alliance PAGroup PAC ID 5193625069, 358 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.78 of 100Reported as group

Quality

65.3

Promoting interoperability

96

Improvement activities

40

Cost

77.31

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trevora.wallace.p2@direct.toa.nextgenshare.com

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.

• Tennessee Orthopaedic Alliance PA

  • Orthopaedic Surgery Physician
  • Nashville, TN
  • NPI 1538153937
  Medicare reassignment Care Compare group NPD
• Tennessee Orthopaedic Alliance PA

  • Multi-Specialty Clinic/Center
  • Clarksville, TN
  • NPI 1336905561
  NPD

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1760058242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306556",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306556",
            "telephone_number": "865-243-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CLINCH AVE STE 106",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162435",
            "telephone_number": "865-633-0259",
            "fax_number": "865-524-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 Park West Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234204",
            "country_code": "US",
            "telephone_number": "865-560-8550",
            "fax_number": "865-560-8551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TREVOR",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery Wallace
• Jessica Wallace, MA, NCC
• Judy C Wallace
• Kaley C Wallace, M.S., CCC-SLP
• Kelsey Spiller Wallace
• Samantha Wallenstein, AU.D.,CCC-A
• Kerri Waller, M.S.
• Thomas Jordan Walley
• Amanda Walls
• Karen F Walls, M.A. CCC-SLP

• Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.