Individual provider Active NPI

Shameka Denise Carter-Mack, FNP-C

  • Family Nurse Practitioner
  • Sumter, SC
National Provider Identifier
1083479117
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29512 Issued in SC
Practice address
755 Electric Dr
Sumter, SC 29153-1933
Phone
(803) 905-5100
Fax
(803) 905-5170
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29512 SC Primary

Addresses

Primary practice location

755 Electric Dr
Sumter, SC 29153-1933

Mailing address

755 Electric Dr
Sumter, SC 29153-1933
Phone (803) 905-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1619 Ruger Dr
Sumter, SC 29150-7916

350 Bedford St
Suite 406a
Stamford, CT 06901-1738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1083479117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 ELECTRIC DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291531933",
            "telephone_number": "803-905-5100",
            "fax_number": "803-905-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 ELECTRIC DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291531933",
            "telephone_number": "803-905-5100",
            "fax_number": "803-905-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER-MACK",
        "first_name": "SHAMEKA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.