Individual provider Active NPI

Shamly Venus Dhiman, M.D.

  • Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1245449354
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33450 Issued in SC
Practice address
1721 Ebenezer Rd Ste 175
Rock Hill, SC 29732-1188
Phone
(803) 324-5256
Fax
(803) 328-0440
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 40388 TN
Surgery Physician 208600000X 244029 NY
Surgery Physician 208600000X 437022 PA
Surgery Physician 208600000X 33450 SC Primary
Surgery Physician 208600000X 2011-00725 NC

Addresses

Primary practice location

1721 Ebenezer Rd Ste 175
Rock Hill, SC 29732-1188

Mailing address

PO Box 604350
Charlotte, NC 28260-4350
Phone (704) 364-8100

Other identifiers 6

IdentifierTypeStateIssuer
02878908MedicaidNY
33450OtherSCMEDICAL LICENSE
2011-00725OtherNCMEDICAL LICENSE
244029OtherNYMEDICAL LICENSE
40388OtherTNMEDICAL LICENSE
334506MedicaidSC

Other names 1

  • Dr. Shamly Venus Amara Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110727000660 SC Practitioner - General Surgery 9234220153 Reassigns benefits to 2 organizations
I20160225000853 NC Practitioner - General Surgery 9234220153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Prep II LLCGroup PAC ID 1052835311, shared by 2 NPIs, 47 clinicians

Practice addresses (Care Compare)

1721 Ebenezer Rd
Suite 175
Rock Hill, SC 29732-1188
Phone (803) 324-5256

7300 Carmel Executive Park Dr
Suite 200
Charlotte, NC 28226-1336
Phone (704) 364-8104

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)19
Mastectomy17
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-00725NCMDSurgery Physician
437022PAMDSurgery Physician
33450SCMDSurgery Physician
40388TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Prep II LLC Surgery CurrentSince Apr 1, 2025 Accepting new patients
Novant Health Prep II LLC Surgery CurrentSince Apr 1, 2025 Accepting new patients
Novant Health Prep II LLC Surgery CurrentSince Apr 1, 2025 Accepting new patients
Novant Health Prep II LLC Surgery Current Accepting new patients
Surgical Specialists of Charlotte, P.a. Surgery CurrentSince Jul 1, 2015 Accepting new patients

Locations

8201 Healthcare Loop
Ste 202
Charlotte, NC 28215
Phone (704) 316-1120

1918 Randolph Rd
Ste 300
Charlotte, NC 28207
Phone (704) 333-0741

7300 Carmel Executive Park Dr
Ste 200
Charlotte, NC 28226
Phone (704) 364-8100

10320 Mallard Creek Rd
Ste 100
Charlotte, NC 28262
Phone (704) 547-9500

10512 Park Rd
Ste 101
Charlotte, NC 28210
Phone (704) 339-1076

1918 Randolph Rd
Ste 130
Charlotte, NC 28207
Phone (704) 316-6005

10030 Gilead Rd
Ste 245
Huntersville, NC 28078
Phone (704) 895-9390

1450 Matthews Township Pkwy
Ste 250
Matthews, NC 28105
Phone (704) 841-1444

1700 1st Baxter Xing
Ste 102
Fort Mill, SC 29708
Phone (704) 342-1900

1721 Ebenezer Rd
Ste 175
Rock Hill, SC 29732
Phone (803) 324-5256

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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 2

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1245449354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604350",
            "telephone_number": "704-364-8100",
            "fax_number": "704-365-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD STE 175",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321188",
            "telephone_number": "803-324-5256",
            "fax_number": "803-328-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHIMAN",
        "first_name": "SHAMLY",
        "middle_name": "VENUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "40388",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "244029",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "437022",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "33450",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2011-00725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02878908",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "33450",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2011-00725",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "244029",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "40388",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334506",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAMLY",
            "last_name": "AMARA",
            "middle_name": "VENUS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.