Active NPI
Shan Fu, PA-C
- Surgical Physician Assistant
- Conway, SC
National Provider Identifier
1255622122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- TL 1641
- Practice address
- 2376 Cypress Cir
Suite 300
Conway, SC 29526-8964 - Phone
- (843) 347-7222
- Fax
- (843) 347-3305
- NPI assigned
- Apr 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | TL 1641 | SC | Primary |
Addresses
Primary practice location
2376 Cypress Cir
Suite 300
Conway, SC 29526-8964
Mailing address
210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
210 Village Ctr Blvd
Myrtle Beach, SC 29579-6706
2376 Cypress Cir
Suite 300
Conway, SC 29526-8995
Phone (843) 353-3460
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1641 | SC | MD | Occupational Therapist |
| TL 1641 | SC | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthosc, LLC | Current | Accepting new patients | |
| Orthosc, LLC | Current | Accepting new patients |
Locations
2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222
210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385
1621 Highway 17 N
North Myrtle Beach, SC 29582
Phone (843) 335-3346
Interoperability endpoints
- https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
- shan.fu.1@17161.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Murrells Inlet, SC
- NPI 1861902728
-
- Orthopaedic Surgery Physician
- Conway, SC
- NPI 1275369787
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Conway, SC
- NPI 1134172000
-
- Rehabilitation Hospital Unit
- Conway, SC
- NPI 1154991487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1255622122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 VILLAGE CENTER BLVD STE 140",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295796706",
"telephone_number": "843-353-3460",
"fax_number": "843-353-3461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2376 CYPRESS CIR",
"address_2": "SUITE 300",
"city": "CONWAY",
"state": "SC",
"postal_code": "295268964",
"telephone_number": "843-347-7222",
"fax_number": "843-347-3305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FU",
"first_name": "SHAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-27",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "SC",
"license": "TL 1641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.