NPIMap

Individual provider Active NPI

Amit G Shah, MD

  • Internal Medicine Physician
  • Indian Land, SC
National Provider Identifier
1740288323
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20170 Issued in SC
Practice address
1040 Edgewater Corp Pkwy Ste 101
Indian Land, SC 29707-4514
Phone
(803) 548-7007
Fax
(803) 802-2015
NPI assigned
Jul 8, 2005
Last updated
Jan 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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 20170 SC Primary

Addresses

Primary practice location

1040 Edgewater Corp Pkwy Ste 101
Indian Land, SC 29707-4514

Mailing address

1040 Edgewater Corp Pkwy Ste 101
Indian Land, SC 29707-4514
Phone (803) 548-7007

Other identifiers 1

IdentifierTypeStateIssuer
T42040MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20050124000179 SC Practitioner - Internal Medicine 6709775562 Reassigns benefits to 3 organizations
I20050825000227 NC Practitioner - Internal Medicine 6709775562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Palmetto Medical Group PLLCGroup PAC ID 5496823817, shared by 2 NPIs, 4 clinicians

Practice addresses (Care Compare)

1040 Edgewater Corp Pkwy
Suite 101
Indian Land, SC 29707
Phone (803) 548-7007

1505 Funny Cide Dr
Waxhaw, NC 28173-7258
Phone (803) 548-7007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18561SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Cardiology Associates LLC CurrentSince Apr 15, 2019 Accepting new patients
Quantum Medical Group LLC Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
Palmetto Medical Group, PLLC Internal Medicine CurrentSince Sep 1, 2008 Accepting new patients
Providence House Calls LLC CurrentSince Feb 29, 2020 Accepting new patients
Palmetto Medical Group, PLLC Internal Medicine CurrentSince Sep 1, 2008 Accepting new patients
Palmetto Tri-County Internal Medicine, PA Internal Medicine PastSince Jun 1, 1999 Accepting new patients
Chester Medical Group, LLC Internal Medicine PastSince Jun 30, 2012 Accepting new patients
University of South Carolina System Past Accepting new patients
Carolina Community Care Inc Past Accepting new patients
Sleep Success Technology, Inc. PastSince Jun 1, 2008 Accepting new patients

Locations

1658 Highway 160 W
Fort Mill, SC 29708
Phone (704) 449-6064

1040 Edgewater Corporate Pkwy
Indian Land, SC 29707
Phone (704) 763-5117

1040 Edgewater Corporate Pkwy
Ste 101
Indian Land, SC 29707
Phone (803) 548-7007

196 Cardiology Dr
Rock Hill, SC 29732
Phone (803) 324-5135

500 Lakeshore Pkwy
Rock Hill, SC 29730
Phone (803) 818-6900

634 Fairview Rd
Simpsonville, SC 29680
Phone (843) 851-3126

Interoperability endpoints

  • Direct secure messaging: amit.shah.p1@direct.cca.nextgenshare.com
  • Direct secure messaging: amit.shah@130915503177732.direct.elationemr.com

Organizations & group practices 10

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1740288323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 EDGEWATER CORP PKWY STE 101",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074514",
            "telephone_number": "803-548-7007",
            "fax_number": "803-802-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EDGEWATER CORP PKWY STE 101",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297074514",
            "telephone_number": "803-548-7007",
            "fax_number": "803-802-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AMIT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "20170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T42040",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Land, SC

Sources for this page

Verify at the official NPI Registry.