Individual provider Active NPI

Nathanael Shane Hornsby, CSFA

  • Surgical Physician Assistant
  • Acworth, GA
National Provider Identifier
1255767950
Registry record updated Oct 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
5330 Brookstone Dr NW Ste 801011
Acworth, GA 30101-7183
Phone
(678) 481-1647
NPI assigned
Sep 25, 2013
Last updated
Oct 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

5330 Brookstone Dr NW Ste 801011
Acworth, GA 30101-7183

Mailing address

5330 Brookstone Dr NW Ste 801011
Acworth, GA 30101-7183
Phone (678) 481-1647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Surgical Assistants, LLC Surgical CurrentSince May 9, 2021 Accepting new patients
Oasis Surgical Assistants LLC PastSince Dec 21, 2021 Accepting new patients
Oasis Surgical Associates LLC PastSince Dec 21, 2025 Accepting new patients

Locations

2537 Cedarcrest Rd
Ste 30514
Acworth, GA 30101
Phone (470) 336-8190

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792972800000",
    "number": "1255767950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 BROOKSTONE DR NW STE 801011",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017183",
            "telephone_number": "678-481-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 BROOKSTONE DR NW STE 801011",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017183",
            "telephone_number": "678-481-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNSBY",
        "first_name": "NATHANAEL",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2026; 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.