Individual provider Active NPI

Michael Shawn Stinson, M.D.

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1265409130
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18052 Issued in SC
Practice address
2 Medical Park Rd
Suite 501
Columbia, SC 29203-6808
Phone
(803) 540-1000
Fax
(803) 540-1050
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18052 SC Primary

Addresses

Primary practice location

2 Medical Park Rd
Suite 501
Columbia, SC 29203-6808

Mailing address

3555 Harden Street Ext
15 Medical Park Suite 300
Columbia, SC 29203-6894
Phone (803) 545-5017

Other identifiers 1

IdentifierTypeStateIssuer
T21358MedicaidSC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18052SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Specialty Clinics - University Primary Care 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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1265409130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT",
            "address_2": "15 MEDICAL PARK SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-545-5017",
            "fax_number": "803-255-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD",
            "address_2": "SUITE 501",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036808",
            "telephone_number": "803-540-1000",
            "fax_number": "803-540-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINSON",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "18052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T21358",
            "state": "SC"
        }
    ],
    "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 29, 2017; 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.