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

Ellis B Wall

Individual provider Physical Therapist · NPI 1578189270

Ellis B Wall is a Physical Therapist in Private Practice in Matthews, North Carolina. Qualified in 2019, 7 years ago. Practices with Fox Rehab PT Nc LLC, a 40-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2008 Moore Rd
Matthews, NC 28105-4978
Phone: (877) 407-3422
Fax: (877) 407-4329
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 136 Corporate Park Dr, Mooresville, NC 28117-6959 — (919) 449-7954

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P19348 (NC)

Record details

NPI number1578189270
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 19, 2020
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025
Mailing address13545 Kintyre Ct, Matthews, NC 28105-3032

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Fox Rehab Pt Nc Llc — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Matthews