DR. COLBY EVAN WALLACE D.P.T.
NPI 1457806622
Physical Therapist - Neurology in Atlanta, GA

Q: What is Colby Wallace's NPI number?

The NPI number for Colby Wallace is 1457806622. It was assigned to this individual provider in the NPPES registry on August 17, 2016.

Q: What is Colby Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Neurology, with taxonomy code 2251N0400X.

Q: When was this NPI record last updated?

The NPPES record for Colby Wallace was last updated on August 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 17, 2016Accepts Medicare Assignment

12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329(404) 778-3444 Get Directions Write a Review

NPPES record last updated: August 17, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Colby Evan Wallace D.p.t. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. COLBY EVAN WALLACE D.P.T. (NPI 1457806622) is an individual neurology provider in Atlanta, Georgia, licensed in Georgia (PT012499) and active in the NPI registry since August 2016. He is a graduate of Other (2016).

NPPES Registry Identity

NPI1457806622

Entity TypeIndividualMale

Primary Taxonomy2251N0400X

Provider Legal NameDR. COLBY EVAN WALLACECredential: D.P.T.

Location Address12 EXECUTIVE PARK DR NEAtlanta, GA 30329-2206

Mailing Address7208 Northlake Heights Cir NeAtlanta, GA 30345-2262 · (615) 653-9596

Phone(404) 778-3444

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateAugust 17, 2016

✔ NPI 1457806622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · NeurologyRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251N0400X

License✔ Licensed in GA · PT012499

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Neurologic Physical Therapy, who has demonstrated specialized knowledge and skill in neuroanatomy and neurophysiology, including knowledge of central, peripheral, and autonomic nervous systems in populations with and without neurologic conditions; motor control and movement sciences in populations with and without neurologic conditions; behavioral sciences, including psychology and neuropsychology, and psychiatry; and medical management and pharmacology.

12 EXECUTIVE PARK DR NE, Atlanta, GA 30329

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Colby Evan Wallace D.p.t. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729456579

PECOS Enrollment IDI20221129000360

Medicare Billing Reassignments

Medicare enrollment records show Colby Wallace reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orthoatlanta, LLC

2.1 mi

Orthopaedic Surgery

3929 PEACHTREE RD NE STE 250
Brookhaven, GA 30319

Reassigned Medicare billing, Georgia enrollment
168 clinicians in this Medicare group

NPI 1265047005 (404) 352-1053

Piedmont Orthopedics, LLC

3.6 mi

Orthopaedic Surgery

105 COLLIER RD NW STE 2000
Atlanta, GA 30309

Reassigned Medicare billing, Georgia enrollment
183 clinicians in this Medicare group

NPI 1114317062 (404) 352-1053

Atlanta Rehabilitation And Performance Center

62 mi

Physical Therapy

448 W KYTLE ST STE C
Cleveland, GA 30528

Reassigned Medicare billing, Georgia enrollment
133 clinicians in this Medicare group

NPI 1982797494 (706) 493-6770

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

954 services56 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

906 services64 patients

Therapy procedure in a group setting 97150

Group therapy involves meeting with a trained therapist alongside others facing similar challenges. It provides a supportive environment to share experiences, learn coping strategies, and gain insights from others. It's a safe space for personal growth and mutual support.

340 services65 patients

Therapy procedure using manual technique, each 15 minutes 97140

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

161 services48 patients

Evaluation for physical therapy, typically 20 minutes 97161

An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.

79 services75 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PEARL VICTORIA RYDER M.D., PH.D.

Student in an Organized Health Care Education/Training Program

12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329

Dekalb County (404) 727-5159

CHRISTI N ACKER DPT, PT

Physical Therapist (Neurology)

12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Dekalb County (404) 778-7777

ORLA MCQUADE FNP-C

Nurse Practitioner (Family)

12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Dekalb County (404) 778-3444

MEGAN LEIGH GOODLIN LCSW

Social Worker (Clinical)

12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Dekalb County (850) 591-6066

PETER ASH MD

Psychiatry & Neurology (Psychiatry)

12 EXECUTIVE PARK DR NE, CHILD PSYCHIATRY, SUITE 200
ATLANTA, GA 30329

Dekalb County (404) 727-3973

KELSEY R SPRANG JONES PSYD

Psychologist (Clinical)

12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Dekalb County (859) 433-5348

BRANDI ANNE BURKE M.D., M.P.H.

Student in an Organized Health Care Education/Training Program

12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329

Dekalb County (404) 727-5159

ROCIO CAROLINA GARCIA SANTIBANEZ M.D.

Psychiatry & Neurology (Neuromuscular Medicine)

12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329

Dekalb County (404) 778-3444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colby Wallace's NPI number?

The NPI number for Colby Wallace is 1457806622. It was assigned to this individual provider in the NPPES registry on August 17, 2016.

Where is Colby Wallace located?

Colby Wallace practices at 12 Executive Park Dr NE, Atlanta, GA 30329. The listed phone number is (404) 778-3444.

What is Colby Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Neurology, with taxonomy code 2251N0400X.

Is Colby Wallace enrolled in Medicare?

Yes. Colby Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Colby Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Colby Wallace reassigns Medicare benefits to 3 organizations: Orthoatlanta, LLC (Brookhaven, GA), Piedmont Orthopedics, LLC (Atlanta, GA) and Atlanta Rehabilitation And Performance Center (Cleveland, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Colby Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Colby Wallace was last updated on August 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.