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

Individual provider Physical Therapist · NPI 1932687886

Johntavis Lamar Mallary, PT is a Physical Therapist in Private Practice in Burlington, North Carolina. Qualified in 2018, 8 years ago. Practices with Benchmark Physical Therapy of North Carolina, LLC, a 240-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
8
Licensed in
NC
In the registry since
2018
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1205 University Dr Unit 112
Burlington, NC 27215-8575
Phone: (336) 542-5111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1991 Fordham Dr Ste 102, Fayetteville, NC 28304-3774 — (910) 484-4653
  • 900 S Franklin St Ste 201, Wake Forest, NC 27587-2799 — (919) 556-1700

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P18256 (NC)

Record details

NPI number1932687886
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 2, 2018
Last updated in NPPESJanuary 21, 2026
Certification dateJanuary 21, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Benchmark Physical Therapy Of North Carolina, Llc — 240 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Burlington