Johntavis Lamar Mallary, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P18256 Issued in NC

Practice address

1205 University Dr Unit 112
Burlington, NC 27215-8575

Phone

(336) 542-5111

NPI assigned

Aug 2, 2018

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 NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benchmark Physical Therapy of North Carolina, LLCGroup PAC ID 1052609278, 242 clinicians

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

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.

• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063
  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  NC, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604

  NC

  Medicare reassignment Care Compare group
• Drayer Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1740605096
  Medicare reassignment NPD
• Physical Therapy and Hand Specialists, LLC

  • Physical Therapist
  • Greensboro, NC
  • NPI 1518382357
  Medicare reassignment NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Wilmington, NC
  • NPI 1205346699
  NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Leland, NC
  • NPI 1588189112
  NPD
• Physical Therapy and Hand Specialist, LLC

  • Physical Therapy Clinic/Center
  • Reidsville, NC
  • NPI 1205251964
  NPD
• Agilitas USA, Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1932687886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-702-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 UNIVERSITY DR UNIT 112",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158575",
            "telephone_number": "336-542-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 S Franklin St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275872799",
            "country_code": "US",
            "telephone_number": "919-556-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Fordham Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043774",
            "country_code": "US",
            "telephone_number": "910-484-4653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLARY",
        "first_name": "JOHNTAVIS",
        "middle_name": "LAMAR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Making Visions Come True, PLLC (Making Visions Assited Living Facility)
• Making Visions Come True, PLLC (Unlimited Care Agency)
• Carole Crump Malek, RN
• Paul Malinda, MD
• Ajaychandra Reddy Malladi, M.D
• Dionne Aaliyah Malone
• Nancy J Maloney, MD
• Adrian Alexander Mancheno Revelo, MD
• Monique Lohmeyer Maness, LCSWA
• Bradley F. Mann, M.P.T.

• Physical Therapist in Burlington, NC
• Providers in Burlington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.