Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

NICOLE LEE WALLACE PTA
NPI 1619884186
Physical Therapy Assistant in Springfield, MO

Active since August 27, 2026
1531 E BRADFORD PKWY STE 210-4, SPRINGFIELD, MO 65804(417) 881-9500 Get Directions Write a Review

NPPES record added: August 27, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Nicole Lee Wallace Pta NPPES

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

NICOLE LEE WALLACE PTA (NPI 1619884186) is an individual physical therapy assistant in Springfield, Missouri, licensed in Missouri (2025036692) and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1619884186
Entity TypeIndividualFemale
Primary Taxonomy225200000X
Provider Legal NameNICOLE LEE WALLACECredential: PTA
Location Address1531 E BRADFORD PKWY STE 210-4Springfield, MO 65804-6539
Mailing Address1531 E Bradford Pkwy Ste 210-4Springfield, MO 65804-6539
Sole ProprietorYes
Enumeration DateAugust 27, 2026
NPPES CertifiedAugust 27, 2026
NPI 1619884186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225200000X
License Licensed in MO · 2025036692
Definition
(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient's responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life.
1531 E BRADFORD PKWY STE 210-4, Springfield, MO 65804

Other Names 1

Former Name (1)Nicole Lee Woolbright

Other Providers at the Same Location NPPES 12

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

Speech-Language Pathologist
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Specialist/Technologist (Speech-Language Assistant)
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Specialist/Technologist (Speech-Language Assistant)
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Occupational Therapy Assistant
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Specialist/Technologist (Speech-Language Assistant)
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Occupational Therapy Assistant
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Durable Medical Equipment & Medical Supplies (Customized Equipment)
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804
Occupational Therapy Assistant
1531 E BRADFORD PKWY STE 210-4
SPRINGFIELD, MO 65804

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 Nicole Wallace's NPI number?

The NPI number for Nicole Wallace is 1619884186. It was assigned to this individual provider in the NPPES registry on August 27, 2026. The provider is also known as Nicole Lee Woolbright.

Where is Nicole Wallace located?

Nicole Wallace practices at 1531 E Bradford Pkwy Ste 210-4, Springfield, MO 65804. The listed phone number is (417) 881-9500.

What is Nicole Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapy Assistant with taxonomy code 225200000X.

When was this NPI record last updated?

The NPPES record for Nicole Wallace was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.