Individual provider Active NPI

Shane Scott Parmer, MD

  • Vascular Surgery Physician
  • Columbia, SC
National Provider Identifier
1780685792
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
35.088549 Issued in OH
Practice address
3 Richland Medical Park Dr Ste 330
Columbia, SC 29203-6862
Phone
(803) 434-7100
Fax
(803) 434-6889
NPI assigned
Aug 2, 2005
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD073786L PA
Vascular Surgery Physician 2086S0129X 87498 SC
Vascular Surgery Physician 2086S0129X 22508 WV
Vascular Surgery Physician 2086S0129X 35.088549 OH Primary

Addresses

Primary practice location

3 Richland Medical Park Dr Ste 330
Columbia, SC 29203-6862

Mailing address

PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500

Other identifiers 5

IdentifierTypeStateIssuer
000000696943OtherOHANTHEM
3810006650MedicaidWV
000000640672OtherOHANTHEM
P00799798OtherOHRRMCR
2708387MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220423000023 SC Practitioner - Vascular Surgery 8820095722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Eastern Virginia Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

805 Pamplico Hwy
Florence, SC 29505-6047
Phone (843) 674-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD073786LPAMDSurgery Physician
35.088549OHMDVascular Surgery Physician
87498SCMDVascular Surgery Physician
22508WVMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Jul 10, 2023 Accepting new patients
Musc Community Physicians Surgery CurrentSince Jul 10, 2023 Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

Interoperability endpoints

  • Direct secure messaging: shane.parmer.p1@direct.scdc.nextgenshare.com
  • Direct secure messaging: shane.parmer@mmhs.medicity.net
  • Direct secure messaging: sparmer431315@direct.musc.edu

Organizations & group practices 3

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1780685792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK DR STE 330",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036862",
            "telephone_number": "803-434-7100",
            "fax_number": "803-434-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARMER",
        "first_name": "SHANE",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD073786L",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "87498",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WV",
            "license": "22508",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.088549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000696943",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006650",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000640672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00799798",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2708387",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.