Individual provider Active NPI

Larry Yancey Shuman, PA-C

  • Physician Assistant
  • Athens, GA
National Provider Identifier
1700869955
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2382 Issued in GA
Practice address
1765 Old West Broad St
Athens, GA 30606-2853
Phone
(706) 549-1663
Fax
(706) 546-8792
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 2382 GA Primary

Addresses

Primary practice location

1765 Old West Broad St
Athens, GA 30606-2853

Mailing address

1765 Old West Broad St BLDG 2-200
Athens, GA 30606-2887
Phone (706) 549-1663

Other practice location 1

209 Mercer Pl
Commerce, GA 30529-1564
Phone (706) 549-1663

Other practice location 2

901 Franklin Springs St
Royston, GA 30662-3911
Phone (706) 549-1663

Other practice location 3

125 King Ave
Athens, GA 30606-6734
Phone (706) 549-1663

Other identifiers 1

IdentifierTypeStateIssuer
12639479OtherCAQH NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address larry.shuman.1@28045.direct.athenahealth.com

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
I20051222000412 GA Practitioner - Physician Assistant 3476575127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Orthopedic Clinic, PAGroup PAC ID 5991600181, 70 clinicians

Practice addresses (Care Compare)

1765 Old W Broad St
Athens, GA 30606-2853
Phone (706) 549-1663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2382GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Orthopedic Clinic, PA CurrentSince May 13, 2018 Accepting new patients
Athens Orthopedic Clinic, PA CurrentSince May 13, 2018 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

1765 Old West Broad St
Ste 200
Athens, GA 30606
Phone (706) 433-4088

1765 Old West Broad St
Bldg 2
Athens, GA 30606
Phone (706) 548-2060

1765 Old West Broad St
Athens, GA 30606
Phone (706) 548-6881

850 King Ave
Athens, GA 30606
Phone (706) 548-2060

125 King Ave
Athens, GA 30606

1765 Old West Broad St
Bldg 2-200
Athens, GA 30606
Phone (706) 433-4088

209 Mercer Pl
Commerce, GA 30529
Phone (706) 583-9000

901 Franklin Springs St
Royston, GA 30662
Phone (706) 245-5040

Interoperability endpoints

  • Direct secure messaging: yshuman@aoc1036.srs-direct.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1700869955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Mercer Pl",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "GA",
            "postal_code": "305291564",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Franklin Springs St",
            "address_purpose": "LOCATION",
            "city": "Royston",
            "state": "GA",
            "postal_code": "306623911",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 King Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306066734",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "LARRY",
        "middle_name": "YANCEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "2382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "12639479",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "larry.shuman.1@28045.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "address_1": "1765 Old West Broad St",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.