Individual provider Active NPI

Stacy Hwang, OTR/L

  • Occupational Therapist
  • Grayson, GA
National Provider Identifier
1033844964
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008475 Issued in GA
Practice address
2065 Grayson Hwy Ste B
Grayson, GA 30017-1766
Phone
(678) 376-0213
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT008475 GA Primary

Addresses

Primary practice location

2065 Grayson Hwy Ste B
Grayson, GA 30017-1766

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Other practice location 1

2089 Teron Trce Ste 120
Dacula, GA 30019-1609
Phone (770) 904-2357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804002317 GA Practitioner - Occupational Therapist in Private Practice 3577924612 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT008475GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Georgia LLC Occupational Therapist CurrentSince Jul 31, 2023 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jul 31, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Jul 31, 2023 Accepting new patients
Resurgens, LLC CurrentSince Aug 27, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Jul 31, 2023 Accepting new patients
Tender Ones Therapy Services, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Atlanta South Physical Therapy, Inc CurrentSince Jul 31, 2023 Accepting new patients
Resurgens, LLC CurrentSince Aug 27, 2025 Accepting new patients

Locations

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

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

1820 Highway 20 SE
Ste 160
Conyers, GA 30013
Phone (770) 922-9222

2089 Teron Trce
Ste 120
Dacula, GA 30019
Phone (770) 904-2357

2065 Grayson Hwy
Ste B
Grayson, GA 30017
Phone (678) 367-0213

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

758 Old Norcross Rd
Ste 175
Lawrenceville, GA 30046
Phone (770) 339-1387

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

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

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

Organizations & group practices 8

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1033844964",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 GRAYSON HWY STE B",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171766",
            "telephone_number": "678-376-0213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2089 Teron Trce Ste 120",
            "address_purpose": "LOCATION",
            "city": "Dacula",
            "state": "GA",
            "postal_code": "300191609",
            "country_code": "US",
            "telephone_number": "770-904-2357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWANG",
        "first_name": "STACY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.