Garrett Wallace
NPI 1306339262ActiveIndividual· Physical Therapist· Summit, MS
Physical Therapist with Professional Rehab Associates, practicing in Summit, Mississippi. Medicare paid $82,059 for services to 193 patients in 2024.
Overview
| NPI | 1306339262 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jun 14, 2018 |
| Last updated in NPPES | Jun 14, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 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 (MS) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 193 |
|---|---|
| Services billed | 4,891 across 15 procedure codes |
| Paid by Medicare | $82,059 |
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Professional Rehab AssociatesMcComb, MS · 7 clinicians
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