Active NPI
William Donald Wages Jr., PTA
- Physical Therapy Assistant
- Swainsboro, GA
National Provider Identifier
1386967305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA001643
- Practice address
- 114 Victory Drive
Swainsboro, GA 30401 - Phone
- (478) 237-4017
- Fax
- (478) 237-3074
- NPI assigned
- Mar 4, 2010
- Last updated
- Mar 4, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA001643 | GA | Primary |
Addresses
Primary practice location
114 Victory Drive
Swainsboro, GA 30401
Mailing address
101 Fairview Park Drive
Dublin, GA 31021
Phone (478) 272-7494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA001643 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Physical Therapy and Rehabilitation Center Inc | Past | Accepting new patients | |
| Bass Physical Therapy and Rehabilitation Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Swainsboro, GA
- NPI 1942347687
-
- Rehabilitation Clinic/Center
- Dublin, GA
- NPI 1952383093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267660800000",
"number": "1386967305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 FAIRVIEW PARK DRIVE",
"city": "DUBLIN",
"state": "GA",
"postal_code": "31021",
"telephone_number": "478-272-7494",
"fax_number": "478-272-2616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 VICTORY DRIVE",
"city": "SWAINSBORO",
"state": "GA",
"postal_code": "30401",
"telephone_number": "478-237-4017",
"fax_number": "478-237-3074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGES",
"first_name": "WILLIAM",
"middle_name": "DONALD",
"name_suffix": "Jr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-04",
"last_updated": "2010-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA001643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Swainsboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.