KELLY LYNN WALLACE DPT
NPI 1750268520
Physical Therapist in Los Angeles, CA

Active since August 21, 2025
6801 PARK TER STE 200, LOS ANGELES, CA 90045(310) 665-7100(310) 665-7101 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Lynn Wallace Dpt NPPES

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

KELLY LYNN WALLACE DPT (NPI 1750268520) is an individual physical therapist in Los Angeles, California, licensed in California (310150) and active in the NPI registry since August 2025. She is a graduate of Other (2025).

NPPES Registry Identity

NPI1750268520
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameKELLY LYNN WALLACECredential: DPT
Location Address6801 PARK TER STE 200Los Angeles, CA 90045-1546
Mailing Address780 E Dorchester DrSaint Johns, FL 32259-6287
Fax(310) 665-7101
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 21, 2025
Last NPPES UpdateMay 26, 2026
NPPES CertifiedMay 26, 2026
NPI 1750268520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Licenses Licensed in CA · 310150 Licensed in FL · PT43619 Licensed in TX · 1407872
Definition

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:<ul><li>Diagnose and manage movement dysfunction and enhance physical and functional abilities.</li><li>Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.</li><li>Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.</li><li>Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.</li><li>Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.</li></ul>PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

6801 PARK TER STE 200, Los Angeles, CA 90045

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kelly Lynn Wallace Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476057043
PECOS Enrollment IDI20250917001570

Other Providers at the Same Location NPPES 13

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

Physical Therapy Assistant
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapy Assistant
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Occupational Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045
Physical Therapist
6801 PARK TER STE 200
LOS ANGELES, CA 90045

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 Kelly Wallace's NPI number?

The NPI number for Kelly Wallace is 1750268520. It was assigned to this individual provider in the NPPES registry on August 21, 2025.

Where is Kelly Wallace located?

Kelly Wallace practices at 6801 Park Ter Ste 200, Los Angeles, CA 90045. The listed phone number is (310) 665-7100.

What is Kelly Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Kelly Wallace enrolled in Medicare?

Yes. Kelly Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Wallace was last updated on May 26, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.