Individual provider Active NPI

Shyam Lal Garg, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Hampstead, NC
National Provider Identifier
1063587095
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
26531 Issued in NC
Practice address
14980 US Highway 17 N
Hampstead, NC 28443-3390
Phone
(910) 270-2722
Fax
(910) 270-0282
NPI assigned
Nov 22, 2006
Last updated
Dec 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26531 NC
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 26531 NC Primary

Addresses

Primary practice location

14980 US Highway 17 N
Hampstead, NC 28443-3390

Mailing address

14980 US Highway 17 N
Hampstead, NC 28443-3390
Phone (910) 270-2722

Other identifiers 2

IdentifierTypeStateIssuer
8934555MedicaidNC
34555OtherNCBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120628000376 NC Practitioner - General PracticePractitioner - Internal Medicine 1951496611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14980 Hwy 17 N
Hampstead, NC 28443
Phone (910) 270-2722

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26531NCMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hampstead Medical Center, PC Geriatric Medicine CurrentSince Jul 1, 1996 Accepting new patients
Hampstead Medical CNTR PC Past Accepting new patients

Locations

14980 US Highway 17
Hampstead, NC 28443
Phone (910) 270-0282

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1063587095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14980 US HIGHWAY 17 N",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433390",
            "telephone_number": "910-270-2722",
            "fax_number": "910-270-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14980 US HIGHWAY 17 N",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433390",
            "telephone_number": "910-270-2722",
            "fax_number": "910-270-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARG",
        "first_name": "SHYAM",
        "middle_name": "LAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "26531",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "26531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8934555",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34555",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.