Individual provider Active NPI

Wade Benjamin Norris III

  • Physical Therapist
  • Valdosta, GA
National Provider Identifier
1386387256
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015533 Issued in GA
Practice address
4274 N Valdosta Rd Ste B
Valdosta, GA 31602-6814
Phone
(229) 433-3870
NPI assigned
Apr 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015533 GA Primary

Addresses

Primary practice location

4274 N Valdosta Rd Ste B
Valdosta, GA 31602-6814

Mailing address

4274 N Valdosta Rd Ste B
Valdosta, GA 31602-6814
Phone (229) 433-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607000004 GA Practitioner - Physical Therapist in Private Practice 0244618072 Reassigns benefits to 1 organization

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
PT Solutions of Acworth LLC 17 clinicians

Practice addresses (Care Compare)

351 Northside Dr
Valdosta, GA 31602-1861
Phone (229) 262-3377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Valdosta and Lowndes County Georgia Past Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist PastSince Apr 24, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 5

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1386387256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4274 N VALDOSTA RD STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026814",
            "telephone_number": "229-433-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4274 N VALDOSTA RD STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026814",
            "telephone_number": "229-433-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "WADE",
        "middle_name": "BENJAMIN",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.