Active NPI
McLean Sheperd, MD, LLC
- Specialist
- Mount Pleasant, SC
National Provider Identifier
1104975663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 18640
- Legal business name
- MCLEAN SHEPERD, MD, LLC
- Practice address
- 852 Lowcountry Blvd
Suite 102
Mount Pleasant, SC 29464-3067 - Phone
- (843) 216-3530
- Fax
- (843) 654-9122
- NPI assigned
- Jan 10, 2007
- Organization subpart
- Yes
- Parent organization
- MCLEAN SHEPERD, MD, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- McLean Sheperd, M.D.
- Title
- Owner
- Phone
- (843) 216-3530
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 18640 | SC | Primary |
Addresses
Primary practice location
852 Lowcountry Blvd
Suite 102
Mount Pleasant, SC 29464-3067
Mailing address
852 Lowcountry Blvd
Suite 102
Mount Pleasant, SC 29464-3067
Phone (843) 216-3530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186408 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614000255 | SC | Part B Supplier - Clinic/Group Practice | 4385628908 |
Receives reassigned benefits from 6 practitioners Practice locations: Mount Pleasant, SC |
National Provider Directory
National Provider Directory- Part of
- McLean Sheperd MD LLC
Locations
912 Old Georgetown Rd
Mt Pleasant, SC 29464
Phone (843) 216-3530
505 Belle Hall Pkwy
Unit 201
Mt Pleasant, SC 29464
Phone (843) 856-3100
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317686400000",
"number": "1104975663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "852 LOWCOUNTRY BLVD",
"address_2": "SUITE 102",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643067",
"telephone_number": "843-216-3530",
"fax_number": "843-654-9122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "852 LOWCOUNTRY BLVD",
"address_2": "SUITE 102",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294643067",
"telephone_number": "843-216-3530",
"fax_number": "843-654-9122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCLEAN SHEPERD, MD, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MCLEAN SHEPERD, MD, LLC",
"enumeration_date": "2007-01-10",
"last_updated": "2011-10-04",
"status": "A",
"authorized_official_last_name": "SHEPERD",
"authorized_official_first_name": "MCLEAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "843-216-3530",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "SC",
"license": "18640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "186408",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.