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

Jake Tyler Wallis

Individual provider Physical Therapist · NPI 1235682238

Jake Tyler Wallis is a Physical Therapist in Private Practice in Morrilton, Arkansas. Qualified in 2016, 10 years ago. Practices with River Valley Therapy and Sports Medicine Inc, a 31-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
10
Licensed in
AR
In the registry since
2016

Practice location Address checks out

100 Walmart Dr Ste 5
Morrilton, AR 72110-4525
Phone: (501) 477-2202
Fax: (501) 421-0543
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (AR)

Record details

NPI number1235682238
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 27, 2016
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025
Mailing address2100 W Main St, Russellville, AR 72801-2758

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice River Valley Therapy And Sports Medicine Inc — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Morrilton