Jessica Wallace
NPI 1760206460ActiveIndividual· Physical Therapist· La Plata, MD
Physical Therapist with La Plata Physical Therapy, practicing in La Plata, Maryland. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1760206460 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Nov 11, 2024 |
| Last updated in NPPES | Nov 11, 2024 |
| Certified by provider | Nov 11, 2024 |
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 (MD) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- La Plata Physical TherapyLa Plata, MD · 4 clinicians
Other physical therapists in La Plata
- 1053590125
- 1104908540
- 1124817275
- 1225212806
- 1295347649
- 1306447008
- 1326492703
- 1477326478
- 1619987955
- 1639195548
- 1689071219
- 1760067771
All 30 physical therapists in La Plata · All physical therapists in Maryland