Shawn Wallace, PT, DPT
NPI 1457323396 · Physical Therapist · Yukon, OK
Enrolled with Medicare as Practitioner - Physical Therapist in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1457323396
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT, DPT
- Sex
- Male
- Sole proprietor
- No
- License
- PT1769 (OK)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
1,490 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Therapy Procedure Using Exercise to Develop Strength, Endurance, Range of Motion, and Flexibility, Each 15 Minutes97110 | 491 | $19 |
| Therapy Procedure to Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes97112 | 436 | $26 |
| Therapy Procedure Using Manual Technique, Each 15 Minutes97140 | 342 | $18 |
| Application of Mechanical Traction97012 | 116 | $10 |
| Electrical Stimulation (unattended), to One Or More Areas for Indication(s) Other Than Wound Care, As Part of a Therapy Plan of CareG0283 | 57 | $8 |
| Evaluation for Physical Therapy, Typically 30 Minutes97162 | 26 |
Practice location
Mailing address
Additional practice locations (1)
- 13390 Ne 23rd StChoctaw, OK 73020-8622Phone: (405) 769-5555Fax: (405) 769-5558
Registry dates
- Enumerated
- 2006-02-05
- Last updated
- 2026-01-21
- Certified
- 2026-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.