NPIMap

Individual provider Active NPI

David J Shin, MD

  • Cardiovascular Disease Physician
  • Rockingham, NC
National Provider Identifier
1952385973
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
11938 Issued in NH
Practice address
106 Physicians Park Drive
Rockingham, NC 28376-7998
Phone
(910) 895-7227
Fax
(910) 895-7089
NPI assigned
Dec 2, 2005
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 11938 NH Primary

Addresses

Primary practice location

106 Physicians Park Drive
Rockingham, NC 28376-7998

Mailing address

PO Box 843232
Boston, MA 02284-3232
Phone (910) 895-7227

Other identifiers 3

IdentifierTypeStateIssuer
30203606MedicaidNH
1650366OtherCIGNA
01Y004791NH01OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20121029000772 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224008594 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCPC-5 LLCGroup PAC ID 4284881012, 31 clinicians
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

Practice addresses (Care Compare)

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-7650

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (856) 848-3227

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.95 of 100Reported as group
Quality
65.05
Promoting interoperability
78
Improvement activities
40
Cost
87.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11938NHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-8, LLC CurrentSince May 1, 2022 Accepting new patients
MCPC-8, LLC CurrentSince May 1, 2022 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Feb 15, 2019 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Feb 15, 2019 Accepting new patients
MCPC-5, LLC Cardiovascular Disease CurrentSince Nov 5, 2012 Accepting new patients
MCPC-5, LLC Cardiovascular Disease CurrentSince Nov 5, 2012 Accepting new patients
MCPC-8, LLC Current Accepting new patients
First Coast Cardiovascular Institute LLC Past Accepting new patients
MCPC-5, LLC Cardiovascular Disease Past Accepting new patients
Rutherford Internal Medicine Associates PA Internal Medicine Past Accepting new patients
MCPC-5, LLC Cardiovascular Disease Past Accepting new patients
Northeast Cardiology Associates Cardiovascular Disease Past Accepting new patients

Locations

108 Endo Ln
Ste 1
Hamlet, NC 28345
Phone (910) 205-8909

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

106 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 417-4105

7473 NC 22 Hwy
Whispering Pines, NC 28327
Phone (910) 215-5100

Interoperability endpoints

  • Direct secure messaging: dshin8765@firsthealth.direct-ci.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/IEIHCA

Organizations & group practices 12

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 5

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1952385973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843232",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022843232",
            "telephone_number": "910-895-7227",
            "fax_number": "910-895-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PHYSICIANS PARK DRIVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283767998",
            "telephone_number": "910-895-7227",
            "fax_number": "910-895-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "11938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203606",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1650366",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "01Y004791NH01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

Verify at the official NPI Registry.