Individual provider Active NPI

Shawn P Fagan, M.D.

  • Surgery Physician
  • Augusta, GA
National Provider Identifier
1265448500
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
73150 Issued in GA
Practice address
3675 J Dewey Gray Cir
Ste. 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
Fax
(888) 745-3917
NPI assigned
Jul 31, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 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 73150 GA Primary
Surgical Critical Care Physician 2086S0102X MD37935 SC
Surgical Critical Care Physician 2086S0102X K5294 TX
Surgical Critical Care Physician 2086S0102X 0101268805 VA
Surgical Critical Care Physician 2086S0102X 73150 GA

Addresses

Primary practice location

3675 J Dewey Gray Cir
Ste. 300
Augusta, GA 30909-1868

Mailing address

PO Box 3726
Augusta, GA 30914-3726
Phone (706) 863-9595

Other practice location 1

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC, TX, VA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20150305000669 GA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists)Practitioner - Undersea and Hyperbaric Medicine 0749284727 Reassigns benefits to 1 organization
I20150611001405 SC Practitioner - Critical Care (Intensivists) 0749284727 Reassigns benefits to 1 organization
I20170519000215 TX Practitioner - General Surgery 0749284727 Reassigns benefits to 1 organization
I20210407000316 VA Practitioner - General Surgery 0749284727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Baylor College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph M Still Burn Centers, IncGroup PAC ID 7618963638, 47 clinicians

Practice addresses (Care Compare)

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

3675 J Dewey Gray Cir
Augusta, GA 30909-1868
Phone (706) 863-9595

3901 W 15TH St
Plano, TX 75075-7738
Phone (706) 863-9595

3950 Austell Rd
Austell, GA 30106-1121
Phone (706) 863-9595

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (706) 863-9595

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue47
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
229893MAMDClinical Social Worker
73150GAMDSurgery Physician
K5294TXMDSurgical Critical Care Physician
0101268805VAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burn and Reconstructive Centers of Nevada, LLC PastSince Jul 1, 2021 Accepting new patients
Joseph M Still Burn Centers, Inc Past Accepting new patients
Burn and Reconstructive Centers of Virginia, PLLC Past Accepting new patients
Burn and Reconstructive Centers of Idaho, PLLC PastSince Jul 1, 2021 Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients
Burn and Reconstructive Centers of Colorado Surgery PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1265448500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "888-745-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR",
            "address_2": "STE. 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "888-745-3917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096521",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "SHAWN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "73150",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "SC",
            "license": "MD37935",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "K5294",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "VA",
            "license": "0101268805",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "73150",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.