James Preston Wallace II, DPT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PTL.0016065 Issued in CO

Practice address

6234 Castlegate Dr W Apt 8112
Castle Rock, CO 80108-8655

Phone

(281) 728-2981

NPI assigned

Nov 13, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1982173571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6234 CASTLEGATE DR W APT 8112",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801088655",
            "telephone_number": "281-728-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6234 CASTLEGATE DR W APT 8112",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801088655",
            "telephone_number": "281-728-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JAMES",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CO",
            "license": "PTL.0016065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co.
• Kaley Walker
• Lecia L Walker
• Melissa Walker, MSP, CCC-SLP
• Alexandria Wallace
• Danielle Wallach, D.O.
• Deshae Waller
• Walmart Inc.
• Lindsey Nicole Walsh, FNP
• Vickie Clark Walsh, CCC-SLP

• Physical Therapy Clinic/Center in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Physical Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.