Active NPI
Micah Stuman
- Physical Medicine & Rehabilitation Physician
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- PT017369
- Practice address
- 758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386 - Phone
- (770) 962-4300
- NPI assigned
- Sep 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT017369 | GA | Primary |
Addresses
Primary practice location
758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386
Mailing address
4025 McGinnis Ferry Rd Apt 510
Suwanee, GA 30024-8323
Phone (770) 722-1813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT017369 | GA | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Current | Accepting new patients | |
| Resurgens, LLC | Current | Accepting new patients |
Locations
2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100
758 Old Norcross Rd
Ste 175
Lawrenceville, GA 30046
Phone (770) 339-1387
758 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 962-4300
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
Interoperability endpoints
- micah.stuman.1@15749.direct.athenahealth.com
Organizations & group practices 2
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.
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- Atlanta, GA
- NPI 1386697928
-
- Orthopaedic Surgery Physician
- Braselton, GA
- NPI 1033919790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1265267371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 MCGINNIS FERRY RD APT 510",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300248323",
"telephone_number": "770-722-1813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "758 OLD NORCROSS RD STE 100",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300463386",
"telephone_number": "770-962-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUMAN",
"first_name": "MICAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-06",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "GA",
"license": "PT017369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.