Individual provider Active NPI

Spencer O. Rowland, PA

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1487907440
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6623 Issued in GA
Practice address
1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574
Phone
(770) 461-1238
Fax
(770) 460-6610
NPI assigned
Oct 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6623 GA Primary

Addresses

Primary practice location

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574

Mailing address

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574
Phone (770) 461-1238

Other identifiers 2

IdentifierTypeStateIssuer
003129131AMedicaidGA
003129131BMedicaidGA

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
I20121113000605 GA Practitioner - Physician Assistant 7315198652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

1336 Hwy 54 W
BLDG 400 Suite C
Fayetteville, GA 30214-4574
Phone (770) 461-6142

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6623GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC PastSince Mar 1, 2022 Accepting new patients

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1487907440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWLAND",
        "first_name": "SPENCER",
        "middle_name": "O.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003129131A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003129131B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.