Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Southern Crescent Medical Center, LLC

Organization Family Medicine Physician · NPI 1578111910

Southern Crescent Medical Center, LLC is a Family Medicine Physician in Stockbridge, Georgia. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3579 Highway 138 SE Ste 103
Stockbridge, GA 30281-4127
Phone: (770) 629-4374
Fax: (678) 545-1735
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Clinical Medical Laboratory Taxonomy 291U00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1578111910
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shantel Bryant — Owner · (770) 629-4374
NPI enumeratedAugust 29, 2019
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025
Mailing address3579 Highway 138 Se Ste 103, Stockbridge, GA 30281-4127

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