NPIMap

Individual provider Active NPI

Mallory Elizabeth Shasteen, M.D.

  • Sports Medicine (Emergency Medicine) Physician
  • Greenville, SC
National Provider Identifier
1174967723
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
39826 Issued in SC
Practice address
701 Grove Rd FL 1
Greenville, SC 29605-4210
Phone
(864) 455-7899
NPI assigned
Apr 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 39826 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 39826 SC
Pediatric Sports Medicine Physician 2080S0010X 39826 SC
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Emergency Medicine) Physician 207PS0010X 39826 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 1
Greenville, SC 29605-4210

Mailing address

300 E McBee Ave Ste 401
Greenville, SC 29601-2842
Phone (864) 522-2286

Other names 1

  • Dr. Mallory Elizabeth Glass Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170728000074 SC Practitioner - Emergency MedicinePractitioner - Sports Medicine 1456645415 Reassigns benefits to 2 organizations
I20181204001340 GA Practitioner - Emergency Medicine 1456645415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Sports Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

300 Scuffletown Rd
Simpsonville, SC 29681-7204
Phone (864) 329-0029

Hospital & facility affiliations

  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39826SCMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Upstate Current Accepting new patients
Prisma Health-Upstate Current Accepting new patients
Prisma Health-Upstate CurrentSince Jul 1, 2017 Accepting new patients
Prisma Health-Upstate Current Accepting new patients
Prisma Health-Upstate CurrentSince Jul 1, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

300 E McBee Ave
Ste 401
Greenville, SC 29601

11402 Anderson Rd
Ste A
Greenville, SC 29611
Phone (864) 631-2799

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

701 Grove Rd
Fl 1
Greenville, SC 29605
Phone (864) 455-7899

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

1115 Wren School Rd
Piedmont, SC 29673
Phone (864) 859-0740

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

300 Scuffletown Rd
Simpsonville, SC 29681
Phone (864) 329-0029

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: mshasteen126319@direct.ghs.myhfn.org

Organizations & group practices 8

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.

Hospital & facility affiliations 47

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1174967723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 401",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTEEN",
        "first_name": "MALLORY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "39826",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "39826",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "SC",
            "license": "39826",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "SC",
            "license": "39826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "GLASS",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.