Tiffany Hope Shepherd

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5007642 Issued in NC

Practice address

6507 North Kings Hwy
Myrtle Beach, SC 29572

Phone

(843) 692-9494

Fax

(843) 692-7474

NPI assigned

Jun 4, 2015

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Tiffany Hope Stephens Tyson Former name

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Carolina Quickcare Family Practice, PLLCGroup PAC ID 0840682340, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ttyson849482@direct.novanthealth.org
• Direct secure messaging: hopetyson@wma.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolina Quickcare Family Practice, PLLC

  dba Carolina QuickCare Family Practice

  • Internal Medicine Physician
  • Biscoe, NC
  • NPI 1881360899
  Medicare reassignment Care Compare group NPD
• County of Columbus Office of Accountant

  dba Columbus County Health Department

  • State or Local Public Health Clinic/Center
  • Whiteville, NC
  • NPI 1699950865
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Oceanside Family Medicine & Convenient Care

  • Family Medicine Physician
  • Shallotte, NC
  • NPI 1710051123
  NPD
• MBD Pharmacy

  • Pharmacist
  • Myrtle Beach, SC
  • NPI 1831060078
  NPD (past)
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1255711297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 NORTH KINGS HWY",
            "address_2": "DR NORMAN'S MYRTLE BEACH DIET & REGENERATIVE CENTER",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-692-9494",
            "fax_number": "843-692-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 NORTH KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-692-9494",
            "fax_number": "843-692-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5145 Sellers Rd",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284703405",
            "country_code": "US",
            "telephone_number": "910-754-4441",
            "fax_number": "910-754-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "TIFFANY",
        "middle_name": "HOPE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NC",
            "license": "5007642",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN.19719",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "TYSON",
            "middle_name": "HOPE STEPHENS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Austin Jennings Shelley, MD
• Catherine Marie Shelton, MAPT
• Lindsay Shelton
• Shelly Carrington Shelton
• Ryan Shepherd, PHARMD
• Julie Jay Shepler, PHARMD
• Karandeep Singh Shergill, M.D.
• Kirby Michelle Shergill, CRNA
• Sheridan Children's Healthcare Services of South Carolina, PA
• Rachel P Sheridan, RN

• Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.