Individual provider Active NPI

Matthew Christian Story, FNP-BC

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1639687627
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21464 Issued in SC
Practice address
3424 Shelby Ray CT
Charleston, SC 29414-5838
Phone
(843) 402-6834
Fax
(843) 573-9963
NPI assigned
Jan 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21464 SC
Family Nurse Practitioner 363LF0000X RN117539 GA
Nurse Practitioner 363L00000X 21464 SC Primary

Addresses

Primary practice location

3424 Shelby Ray CT
Charleston, SC 29414-5838

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other practice location 1

2292 Peachtree Rd NW
Atlanta, GA 30309-1147
Phone (404) 996-0120

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180612000960 SC Practitioner - Nurse Practitioner 4688929896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

1014 Saint Andrews Blvd
Charleston, SC 29407-7177
Phone (843) 556-5585

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

3424 Shelby Ray Ct
Charleston, SC 29414
Phone (843) 402-6834

1014 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 556-5585

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

459 N Highway 52
Moncks Corner, SC 29461
Phone (843) 889-3870

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1639687627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 SHELBY RAY CT",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145838",
            "telephone_number": "843-402-6834",
            "fax_number": "843-573-9963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2292 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091147",
            "country_code": "US",
            "telephone_number": "404-996-0120",
            "fax_number": "404-351-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORY",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTIAN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-12",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21464",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN117539",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.