Organization Active NPI

Sumter Family Medicine & Sports Medicine Center, P.C.

  • Sports Medicine (Family Medicine) Physician
  • Americus, GA
National Provider Identifier
1073775904
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
040628 Issued in GA
Legal business name
SUMTER FAMILY MEDICINE & SPORTS MEDICINE CENTER, P.C.
Practice address
922 E Jefferson St
Suite B
Americus, GA 31709-4780
Phone
(229) 924-2383
Fax
(229) 924-0684
NPI assigned
Jul 1, 2008
Last updated
Jul 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Michael Shane Busman, M.D.NPI 1073584504
Title
M.D.
Phone
(229) 924-2383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QS0010X 040628 GA Primary

Addresses

Primary practice location

922 E Jefferson St
Suite B
Americus, GA 31709-4780

Mailing address

PO Box 6815
Americus, GA 31709-6815
Phone (229) 924-2383

Other identifiers 1

IdentifierTypeStateIssuer
000720893DMedicaidGA

National Provider Directory

National Provider Directory

Locations

1102 E Lamar St
Ste E
Americus, GA 31709
Phone (229) 924-2383

922 E Jefferson St
Ste B
Americus, GA 31709
Phone (229) 924-2383

208 E Lamar St
Ste B
Americus, GA 31709
Phone (229) 924-2383

922 E Jefferson St
Americus, GA 31709

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1073775904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6815",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317096815",
            "telephone_number": "229-924-2383",
            "fax_number": "229-924-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E JEFFERSON ST",
            "address_2": "SUITE B",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094780",
            "telephone_number": "229-924-2383",
            "fax_number": "229-924-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER FAMILY MEDICINE & SPORTS MEDICINE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "BUSMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "229-924-2383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "040628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000720893D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.