Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Southern Crescent Medical Center, LLC

Organization Family Medicine Physician · NPI 1578111910

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

In the registry since
2019
Specialties on file
3
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
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 NPPESSeptember 8, 2026
Certification dateSeptember 8, 2026
Mailing address3579 Highway 138 Se Ste 103, Stockbridge, GA 30281-4127

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