Ifekan-Shango Simon

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22352 Issued in SC

Practice address

853 N Church St
Suite 510
Spartanburg, SC 29303-3098

Phone

(864) 560-1558

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Medical College of Georgia School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Carenow Urgent Care LLCGroup PAC ID 3274893359, 72 clinicians

Medcare Express - North Charleston LLCGroup PAC ID 7618074899, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Medcare Express - North Charleston LLC

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1457579617
  Medicare reassignment Care Compare group
• Anmed Urgent Care LLC

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1467289637
  Medicare reassignment NPD
• Charleston Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Goose Creek, SC
  • NPI 1093248288
  Care Compare group
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1992742837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST",
            "address_2": "SUITE 510",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033077",
            "telephone_number": "864-560-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST",
            "address_2": "SUITE 510",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033098",
            "telephone_number": "864-560-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "IFEKAN-SHANGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "22352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223528",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Siebert, OD
• Scott Michael Silver, MD
• John Walton Simmons Sr., MD
• Mary Elizabeth Simmons, LPC
• Taylor Marie Simmons, D.O.
• Andrew Thomas Simpson, D.O.
• Heber Grant Sims, O.D.
• Stephanie Layne Sims, NP-C
• Tiffany L Sims
• Rachel J Sine, MD

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.