{"npi":"1679567192","type":"NPI-1","status":"active","name":{"display":"Mr. Lawrence Wallace MD, Pt","other":[],"first":"LAWRENCE","last":"WALLACE","credential":"MD, PT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"207X00000X","description":"Orthopaedic Surgery","primary":false,"state":"PA","license":"MD439714"},{"code":"225100000X","description":"Physical Therapist","primary":false,"state":"NC","license":"P2177"},{"code":"207X00000X","description":"Orthopaedic Surgery","primary":false,"state":"VA","license":"0101234728"},{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"SC","license":"11194"}]},"addresses":[{"purpose":"LOCATION","street_1":"1021 2ND AVE N STE 6","city":"NORTH MYRTLE BEACH","state":"SC","postal_code":"295823200","country_code":"US","phone":"8432865168","fax":"8443188980"},{"purpose":"MAILING","street_1":"1021 2ND AVE N STE 6","city":"NORTH MYRTLE BEACH","state":"SC","postal_code":"295823200","country_code":"US","phone":"8432865168","fax":"8443188980"}],"license":{"state":"SC","number":"11194"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"010114446","state":"VA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20260123001478","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"SC","pac_id":"4082678669"}]},"enumeration_date":"2005-09-12","last_updated":"2026-01-26","_meta":{"source":"NPPES","snapshot_date":"2026-01-26","doc_url":"https://findmynpi.com/api"}}