Individual provider Active NPI

Shannon McAvoy Carmignani, DPM

  • Podiatrist
  • Summerville, SC
National Provider Identifier
1710564885
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
762 Issued in SC
Practice address
208 E 2ND North St
Summerville, SC 29483-2157
Phone
(843) 904-5061
NPI assigned
Mar 25, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 762 SC Primary

Addresses

Primary practice location

208 E 2ND North St
Summerville, SC 29483-2157

Mailing address

972 Sumter Hwy
Kingstree, SC 29556-4948
Phone (203) 312-3798

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904003479 SC Practitioner - Podiatry 1850831918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy Feet of SC LLCGroup PAC ID 8224457502, 10 clinicians

Practice addresses (Care Compare)

218 Granito Dr
Greer, SC 29650-2771
Phone (248) 528-2116

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1488
Removal or shaving of skin growth51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
762SCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Feet of SC LLC Podiatrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 128
Louisville, KY 40243

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (502) 214-4812

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1710564885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 SUMTER HWY",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295564948",
            "telephone_number": "203-312-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E 2ND NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294832157",
            "telephone_number": "843-904-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMIGNANI",
        "first_name": "SHANNON",
        "middle_name": "MCAVOY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.