DR. CHRISTOPHER TRAVIS SHADY (NPI# 1538541669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538541669 |
| Entity Type | Individual |
| Full Name | DR. CHRISTOPHER TRAVIS SHADY |
| Credential | DO |
| Practice Address |
2435 Forest Dr Columbia SC 29204-2026 |
| Practice Telephone | 8032565300 |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 34.013445 | OH | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | DO52105 | SC | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 5101021834 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
2435 FOREST DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811290 | Providence Hospital, LLC | General Acute Care Hospital | 2435 Forest Dr, Columbia, SC 29204-2026 | 2005-06-15 |
| 1184271223 | Taylor Trull | Physician Assistant | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-08-22 |
| 1336794262 | Jillian Janss | Physical Therapist | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-08-07 |
| 1962063115 | Meagan Kirkley Wall | Nurse Anesthetist, Certified Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-06-27 |
| 1003376757 | Abigail Gottshall | Dietitian, Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-03-20 |
| 1053875120 | Smita Patel | Specialist/Technologist, Other | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-01-23 |
| 1538662556 | Prunetta Brunson | Nurse Practitioner | 2435 Forest Dr, Columbia, SC 29204-2026 | 2018-03-15 |
| 1164925863 | Sheltana Michelle Hipps | Nurse Practitioner | 2435 Forest Dr, Columbia, SC 29204-2026 | 2018-03-09 |
| 1154841021 | Broad River Physicians Group, LLC | Emergency Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2017-06-22 |
| 1659818599 | Providence Professional Services LLC | Emergency Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2017-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808815 | Thai Quoc Nguyen | Internal Medicine | University Hospital Ma421 Med Sciences Bldg, Columbia, MO 65212-0001 | 2020-07-06 |
| 1649898784 | Peter Egwom | Internal Medicine | University Hospital One Hospital Drive Dc.043.00, Columbia, MO 65212-0001 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1851918346 | Maxwell Isaac | Internal Medicine | University Hospital 1 Hospital Drive Dc 043.00, Columbia, MO 65212-0001 | 2020-06-30 |
| 1285251983 | Shannon Ejiofor | Internal Medicine | University Hospital One Hospital Drive Dc043.00, Columbia, MO 65212-0001 | 2020-06-29 |
| 1336766278 | Jordan Stauffer | Internal Medicine | University Hospital One Hospital Dr, Columbia, MO 65212-0001 | 2020-06-26 |
| 1972120814 | Pak Ho Au | Internal Medicine | University Hospital One Hospital Dr Dc043.00, Columbia, MO 65212-0001 | 2020-06-26 |
| 1700402849 | Michael Allan Goble | Internal Medicine | Internal Medical Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-24 |
| 1740806389 | Alan Verl Godfrey | Internal Medicine | University of Missouri Hospital 1 Hospital Dr, Columbia, MO 65212-0001 | 2020-06-19 |
| 1003432642 | Gregory Gaskey | Internal Medicine | University of Missouri Hospital One Hospital Drive, Columbia, MO 65212-0001 | 2020-06-19 |
| Find all providers in COLUMBIA | ||||
Please comment or provide details below to improve the information on DR. CHRISTOPHER TRAVIS SHADY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.