Individual provider Active NPI

Michael Shane Dewitt, D.O.

  • Family Medicine Physician
  • South Charleston, WV
National Provider Identifier
1760485593
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1255 Issued in WV
Practice address
506 Chestnut Street
South Charleston, WV 25309-1402
Phone
(304) 766-8558
Fax
(304) 766-8561
NPI assigned
May 24, 2005
Reactivated
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1255 WV Primary

Addresses

Primary practice location

506 Chestnut Street
South Charleston, WV 25309-1402

Mailing address

4605 Maccorkle Ave SW
THS Physician Partners, Inc.-Admin Ofc
South Charleston, WV 25309-1311
Phone (304) 414-4800

Other practice location 1

333 Laidley St
Charleston, WV 25301-1614
Phone (304) 347-6773

Other practice location 2

6A Bank St
Nitro, WV 25143-1708
Phone (304) 306-3058

Other practice location 3

4605 MacCorkle Ave SW Ofc
South Charleston, WV 25309-1311
Phone (304) 414-4800

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address michael.dewitt@thomashealthsystem.direct-ci.com
Direct Messaging Address michael.dewitt@thomashealthsystem.direct-ci.com
Direct Messaging Address michael.dewitt@thomashealthsystem.direct-ci.com
Direct Messaging Address michael.dewitt@thomashealthsystem.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000018 WV Practitioner - Family Practice 3678523115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

506 Chestnut St
South Charleston, WV 25309-1204
Phone (304) 766-8558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1255WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
THS Physician Partners Inc Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
DRS Dewitt & Gibson, PLLC Family Medicine PastSince Dec 13, 2004 Accepting new patients

Locations

L3539
Columbus, OH 43260
Phone (304) 414-4800

333 Laidley St
Charleston, WV 25301
Phone (304) 347-6116

6A Bank St
Nitro, WV 25143
Phone (304) 306-3058

506 Chestnut St
South Charleston, WV 25309
Phone (304) 766-8558

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

4605 Maccorkle Ave SW
Ofc
South Charleston, WV 25309
Phone (304) 414-4800

Interoperability endpoints

  • Direct secure messaging: mdewitt535206@direct.wvuhsdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1760485593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "address_2": "THS PHYSICIAN PARTNERS, INC.-ADMIN OFC",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800",
            "fax_number": "304-414-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CHESTNUT STREET",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091402",
            "telephone_number": "304-766-8558",
            "fax_number": "304-766-8561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Laidley St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011614",
            "country_code": "US",
            "telephone_number": "304-347-6773",
            "fax_number": "304-347-6848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6A Bank St",
            "address_purpose": "LOCATION",
            "city": "Nitro",
            "state": "WV",
            "postal_code": "251431708",
            "country_code": "US",
            "telephone_number": "304-306-3058",
            "fax_number": "304-306-3059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4605 MacCorkle Ave SW Ofc",
            "address_purpose": "LOCATION",
            "city": "South Charleston",
            "state": "WV",
            "postal_code": "253091311",
            "country_code": "US",
            "telephone_number": "304-414-4800",
            "fax_number": "304-414-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.dewitt@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "6A Bank St",
            "city": "Nitro",
            "state": "WV",
            "country_code": "US",
            "postal_code": "251431708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.dewitt@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "333 Laidley St",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253011614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.dewitt@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "506 Chestnut Street",
            "city": "South Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253091402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.dewitt@thomashealthsystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "4605 MacCorkle Ave SW Ofc",
            "city": "South Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253091311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.