Individual provider Active NPI

Spencer Rice, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1104460096
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10147 Issued in GA
Practice address
1220 Caroline St NE Ste a-230
Atlanta, GA 30307-2749
Phone
(678) 710-3980
NPI assigned
Nov 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10147 GA Primary
Physician Assistant 363A00000X 9112730 FL

Addresses

Primary practice location

1220 Caroline St NE Ste a-230
Atlanta, GA 30307-2749

Mailing address

1068 Palafox Dr NE
Atlanta, GA 30324-4526
Phone (918) 671-7098

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
I20210319001638 GA Practitioner - Physician Assistant 5991115990 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gwinnett Emergency Specialists, LLCGroup PAC ID 0840373619, 50 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10147GAMDProfessional Counselor
9112730FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Emergency Specialists, LLC Physician Assistant CurrentSince Jan 13, 2026 Accepting new patients

Locations

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

Organizations & group practices 6

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1104460096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 PALAFOX DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244526",
            "telephone_number": "918-671-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CAROLINE ST NE STE A-230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072749",
            "telephone_number": "678-710-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10147",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.