NPIMap

Individual provider Active NPI

Sijie Joy Shen-Wagner, MD

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1750601886
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38737 Issued in SC
Practice address
877 W Faris Rd Ste a
Greenville, SC 29605-4296
Phone
(864) 455-7800
Fax
(803) 434-7231
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME116152 FL
Family Medicine Physician 207Q00000X 38737 SC Primary

Addresses

Primary practice location

877 W Faris Rd Ste a
Greenville, SC 29605-4296

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6174

Other identifiers 3

IdentifierTypeStateIssuer
387370MedicaidSC
009096500MedicaidFL
14R6SOtherFLBCBSFL

Other names 1

  • Sijie Joy Shen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151121000140 SC Practitioner - Family Practice 8123269552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

877 W Faris Rd
Suite a
Greenville, SC 29605-4296
Phone (864) 455-8147

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 6, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 6, 2018 Accepting new patients
Prisma Health University Medical Group Family Medicine Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 28, 2016 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Oct 28, 2016 Accepting new patients

Locations

2 Medical Park Rd
Ste 203
Columbia, SC 29203
Phone (803) 212-7130

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3209 Colonial Dr
Columbia, SC 29203
Phone (803) 434-6113

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

877 W Faris Rd
Greenville, SC 29605
Phone (864) 455-7800

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

877 W Faris Rd
Ste A
Greenville, SC 29605
Phone (864) 455-7800

Interoperability endpoints

  • Direct secure messaging: sshenwagner235329@direct.ghs.myhfn.org

Organizations & group practices 5

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1750601886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FARIS RD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054296",
            "telephone_number": "864-455-7800",
            "fax_number": "803-434-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN-WAGNER",
        "first_name": "SIJIE",
        "middle_name": "JOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116152",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "38737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387370",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009096500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "14R6S",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIJIE",
            "last_name": "SHEN",
            "middle_name": "JOY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.