Individual provider Active NPI

Shane D Hemphill, MD

  • Family Medicine Physician
  • Holly Springs, NC
National Provider Identifier
1093997645
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011-01595 Issued in NC
Practice address
781 Avent Ferry Rd Ste 310
Holly Springs, NC 27540-7776
Phone
(919) 552-8914
Fax
(919) 552-8955
NPI assigned
Dec 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME102888 FL
Student in an Organized Health Care Education/Training Program 390200000X P19555 MD
Family Medicine Physician 207Q00000X 2011-01595 NC Primary

Addresses

Primary practice location

781 Avent Ferry Rd Ste 310
Holly Springs, NC 27540-7776

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shemphill10818@direct.UNC.nchie.net Direct

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
I20120224000716 NC Practitioner - Family Practice 7113081266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1617 N Main St
Suite 100
Fuquay Varina, NC 27526-9021
Phone (919) 577-9952

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-01595NCMDFamily Medicine Physician
P19555MDMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Family Medicine CurrentSince Apr 7, 2013 Accepting new patients
Unc Physicians Network LLC Family Medicine Current Accepting new patients
Rex Hospital, Inc. Past Accepting new patients

Locations

1515 SW Cary Pkwy
Ste 200
Cary, NC 27511
Phone (919) 387-3178

1515 SW Cary Pkwy
Ste 130
Cary, NC 27511
Phone (919) 387-3180

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

1617 N Main St
#100
Fuquay Varina, NC 27526
Phone (919) 577-9952

208 Village Walk Dr
Holly Springs, NC 27540
Phone (919) 552-8911

781 Avent Ferry Rd
Ste 310
Holly Springs, NC 27540
Phone (919) 552-8911

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

1600 Perimeter Park Dr
Ste 225
Morrisville, NC 27560
Phone (919) 804-5064

Interoperability endpoints

  • Direct secure messaging: shemphill10818@direct.unc.nchie.net

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 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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1093997645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 AVENT FERRY RD STE 310",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407776",
            "telephone_number": "919-552-8914",
            "fax_number": "919-552-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMPHILL",
        "first_name": "SHANE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME102888",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "P19555",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-01595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shemphill10818@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "781 Avent Ferry Rd Ste 310",
            "city": "Holly Springs",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275407776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.