Individual provider Active NPI

Alyssa Norris

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1053802595
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
141 Lacy St NW Ste 100
Marietta, GA 30060-1117
Phone
(770) 442-1911
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

141 Lacy St NW Ste 100
Marietta, GA 30060-1117

Mailing address

1393 Sheffield Pkwy
Marietta, GA 30062-2742
Phone (920) 740-8458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210414001782 GA Practitioner - Physician Assistant 3678981511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

1255 Friendship Rd
Suite 130
Braselton, GA 30517-5617
Phone (770) 442-1911

141 Lacy St NW
Suite 100
Marietta, GA 30060-1117
Phone (770) 442-1911

4865 Lavista Rd
Suite a
Tucker, GA 30084-4436
Phone (770) 442-1911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1053802595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1393 SHEFFIELD PKWY",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622742",
            "telephone_number": "920-740-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LACY ST NW STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601117",
            "telephone_number": "770-442-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.