Individual provider Active NPI

Dewey Wilson, DPT

  • Physical Therapist
  • Thomasville, GA
National Provider Identifier
1306509310
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015975 Issued in GA
Practice address
511 Gordon Ave
Thomasville, GA 31792-6645
Phone
(229) 228-9019
NPI assigned
Oct 16, 2021
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X PT015975 GA Primary

Addresses

Primary practice location

511 Gordon Ave
Thomasville, GA 31792-6645

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-8923

Other practice location 1

104 Walnut Ln Ste 106
North Augusta, SC 29860-8684
Phone (803) 599-5990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220411002420 SC Practitioner - Physical Therapist in Private Practice 4183010523 Reassigns benefits to 1 organization
I20220711001092 GA Practitioner - Physical Therapist in Private Practice 4183010523 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2235 Harrison Rd SE
Thomson, GA 30824-7457
Phone (706) 842-2820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10861SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jul 1, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

254 Robert C Daniel Jr Pkwy
Ste 4B
Augusta, GA 30909
Phone (706) 723-5795

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

1227 Rockbridge Rd
Ste 402
Stone Mtn, GA 30087
Phone (770) 925-9210

511 Gordon Ave
Thomasville, GA 31792
Phone (229) 226-5616

2235 Harrison Rd SE
Thomson, GA 30824
Phone (706) 842-2820

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

104 Walnut Ln
Ste 106
North Augusta, SC 29860
Phone (803) 599-5990

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1306509310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926645",
            "telephone_number": "229-228-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Walnut Ln Ste 106",
            "address_purpose": "LOCATION",
            "city": "North Augusta",
            "state": "SC",
            "postal_code": "298608684",
            "country_code": "US",
            "telephone_number": "803-599-5990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEWEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-16",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.