Mackenzie Wall, DPT
NPI 1194454058ActiveIndividual· Physical Therapist· Smithfield, NC
Physical Therapist (DPT) in Smithfield, North Carolina, licensed in NC, with an NPI issued in June 2022. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1194454058 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Jun 7, 2022 |
| Last updated in NPPES | Aug 18, 2025 |
| Certified by provider | Aug 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | P21317 | NC |
| Physical Therapist | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NC) |
|---|
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All 32 physical therapists in Smithfield · All physical therapists in North Carolina