Individual provider Active NPI

Thomas Stuckey, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Villa Rica, GA
National Provider Identifier
1083189328
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP280533 Issued in GA
Practice address
20 Herrell Rd
Villa Rica, GA 30180-5527
Phone
(770) 812-3294
NPI assigned
Oct 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP280533 GA Primary

Addresses

Primary practice location

20 Herrell Rd
Villa Rica, GA 30180-5527

Mailing address

20 Herrell Rd
Villa Rica, GA 30180-5527
Phone (770) 812-3294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122000078 GA Practitioner - Nurse Practitioner 6406281476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
TMC-Behavioral Health of West GeorgiaGroup PAC ID 2163714635, 37 clinicians

Practice addresses (Care Compare)

101 Quartz Dr
Suite 103B
Villa Rica, GA 30180-3201
Phone (770) 812-3580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP280533GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC-Behavioral Health of West Georgia CurrentSince Oct 7, 2019 Accepting new patients

Locations

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

101 Quartz Dr
Ste 103B
Villa Rica, GA 30180
Phone (770) 812-3580

Organizations & group practices 1

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": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1083189328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "THOMAS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP280533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.