Laurri Wallace, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT006593 Issued in GA

Practice address

1004 Bankhead Hwy
BLDG a, Ste 5
Carrollton, GA 30117-1852

Phone

(770) 834-5609

Fax

(267) 321-1352

NPI assigned

Nov 6, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Premise Health of Georgia Medical PC

  • Family Medicine Physician
  • Carrollton, GA
  • NPI 1437213709
  NPD
• Matrix Rehabilitation-Georgia Inc

  • Physical Therapy Clinic/Center
  • Carrollton, GA
  • NPI 1376574764
  NPD (past)
• Matrix Rehabilitation-Georgia Inc

  • Physical Therapy Clinic/Center
  • McDonough, GA
  • NPI 1659302966
  NPD (past)
• Neurosport Physical Therapy & Rehabilitation Specialist Inc.

  • Physical Therapist
  • Marietta, GA
  • NPI 1376546341
  NPD (past)
• Rehab Associates, LLC

  • Physical Therapy Clinic/Center
  • Jasper, AL
  • NPI 1033886486

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1801975255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 BANKHEAD HWY",
            "address_2": "BLDG A, STE 5",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301171852",
            "telephone_number": "770-834-5609",
            "fax_number": "267-321-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 BANKHEAD HWY",
            "address_2": "BLDG A, STE 5",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301171852",
            "telephone_number": "770-834-5609",
            "fax_number": "267-321-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAURRI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "PT006593",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Melissa Devon Walker, NP
• Garrett James Wallace
• Candler Lindsey Walls Jr., RPH
• Hollis Paul Walls, D.M.D.
• Sheila Reece Walls
• Mari Lynne Walson, PT, DPT
• Evah Wangungu

• Physical Therapist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.