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

Marisa Wallace, DPT

Individual provider Physical Therapist · NPI 1861115362

Marisa Wallace, DPT is a Physical Therapist in Private Practice in Hampstead, North Carolina. Qualified in 2022, 4 years ago. Practices with Zumbro and Connell Inc, a 38-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

14057 US Highway 17 Ste 230
Hampstead, NC 28443-3999
Phone: (910) 821-3377
Fax: (910) 821-3380
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P21665 (NC)

Record details

NPI number1861115362
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 21, 2022
Last updated in NPPESNovember 21, 2025
Certification dateNovember 21, 2025
Mailing address5710 Oleander Drive Ste 211, Wilmington, NC 28403-5390

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Zumbro And Connell Inc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hampstead