Individual provider Active NPI

Edward Shmunes, M.D.

  • Dermatology Physician
  • Columbia, SC
National Provider Identifier
1073811253
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
SC6977 Issued in SC
Practice address
3701 Northshore Rd
Columbia, SC 29206-3365
Phone
(803) 787-6314
NPI assigned
Mar 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X SC6977 SC Primary

Addresses

Primary practice location

3701 Northshore Rd
Columbia, SC 29206-3365

Mailing address

3701 Northshore Rd
Columbia, SC 29206-3365
Phone (803) 787-6314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6977SCMDProfessional Counselor
SC6977SCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CSC Acquisition, LLC Dermatology Past 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": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1073811253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 NORTHSHORE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063365",
            "telephone_number": "803-787-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 NORTHSHORE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063365",
            "telephone_number": "803-787-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHMUNES",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "SC6977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.