Hailey Lynn Wagner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36009 Issued in FL

Practice address

1950 Bluewater Blvd Ste 100
Niceville, FL 32578-3888

Phone

(850) 807-4200

NPI assigned

Sep 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Hailey Lynn Norris Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hailey.wagner.1@9109.direct.athenahealth.com

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.

• North Florida Surgeons, PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1912953290
  Medicare reassignment Care Compare group NPD
• Premier Rehab Management, LLC

  • Physical Therapist
  • Navarre, FL
  • NPI 1821014390
  Medicare reassignment NPD
• North Florida Surgeons, PA

  • Orthopaedic Surgery Physician
  • Gulf Breeze, FL
  • NPI 1871442053
  NPD
• Premier Rehab Management, LLC

  • Physical Therapist
  • Panama City Beach, FL
  • NPI 1700219599
  NPD
• Gulf Breeze Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Pensacola, FL
  • NPI 1730183153

  Physical Therapist

  NPD (past)
• Rehabclinics SPT Inc

  • Physical Therapist
  • Eldersburg, MD
  • NPI 1164427092
  NPD (past)

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1821602947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE STE 1400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393067",
            "telephone_number": "678-981-3543",
            "fax_number": "404-777-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD STE 100",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783888",
            "telephone_number": "850-807-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7030 Pine Forest Rd",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325263920",
            "country_code": "US",
            "telephone_number": "850-944-5360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8199 Navarre Pkwy Unit 12A",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325666941",
            "country_code": "US",
            "telephone_number": "850-939-1233",
            "fax_number": "850-939-5097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "HAILEY",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PT36009",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAILEY",
            "last_name": "NORRIS",
            "middle_name": "LYNN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jayda Renae Varner
• Victor Vega-Mercado
• Kimberly Vele
• Olivia Victor, RBT
• Jodi L. Visi
• Susan M Wagner, ARNP, CRNP, FNP-C
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Walgreen Co
• Sherry Dawn Walker, L.P.N

• Physical Therapist in Niceville, FL
• Providers in Niceville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.