Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Camron Wallace

Individual provider Orthopedic Physical Therapist · NPI 1306685722

Camron Wallace is a Physical Therapist in Private Practice in Shelby, North Carolina. Qualified in 2024, 2 years ago. Practices with Ivyrehab North Carolina LLC, a 154-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2024
Specialties on file
2

Practice location Address checks out

1129 E Marion St
Shelby, NC 28150-4843
Phone: (704) 471-0001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P23482 (NC)
Orthopedic Physical Therapist Taxonomy 2251X0800X

Record details

NPI number1306685722
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 23, 2024
Last updated in NPPESAugust 13, 2024
Certification dateAugust 13, 2024
Mailing address1416 Crestview Dr, Shelby, NC 28150-4267

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Ivyrehab North Carolina Llc — 154 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Shelby