NPIMap

Individual provider Active NPI

Christopher Travis Shady, DO

  • Internal Medicine Physician
  • Columbia, SC
National Provider Identifier
1538541669
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO52105 Issued in SC
Practice address
2435 Forest Dr
Columbia, SC 29204-2026
Phone
(803) 256-5300
NPI assigned
Jun 25, 2015
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101021834 MI
Internal Medicine Physician 207R00000X 34.013445 OH
Internal Medicine Physician 207R00000X DO52105 SC Primary

Addresses

Primary practice location

2435 Forest Dr
Columbia, SC 29204-2026

Mailing address

2435 Forest Dr
Columbia, SC 29204-2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180725003542 OH Practitioner - HospitalistPractitioner - Internal Medicine 2769792985 Reassigns benefits to 1 organization
I20181015003117 SC Practitioner - HospitalistPractitioner - Internal Medicine 2769792985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group South CarolinaGroup PAC ID 8921193020, 69 clinicians

Practice addresses (Care Compare)

2435 Forest Dr
Columbia, SC 29204-2026
Phone (803) 256-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.99 of 100Reported as group
Quality
81.65
Improvement activities
40
Cost
74.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.013445OHMDInternal Medicine Physician
DO52105SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Ohio Inc Internal Medicine CurrentSince Jun 22, 2018 Accepting new patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince Jul 21, 2018 Accepting new patients
Medical University Hospital Authority Past Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

Interoperability endpoints

  • Direct secure messaging: cshady380517@direct.musc.edu

Organizations & group practices 4

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 5

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1538541669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "803-256-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADY",
        "first_name": "CHRISTOPHER",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101021834",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.013445",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "DO52105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.