Shannan Karlayne Toole Dufault, NPN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2139 Issued in SC

Practice address

2016 1St Ave
Summerville, SC 29486-0408

Phone

(843) 873-4545

Fax

(843) 873-1561

NPI assigned

Aug 29, 2006

Last updated

Feb 3, 2025By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kdufault@sp.gwaydirect.com

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1275641144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 RIVERTOWNE COUNTRY CLUB DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668700",
            "telephone_number": "843-270-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 1ST AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860408",
            "telephone_number": "843-873-4545",
            "fax_number": "843-873-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOLE DUFAULT",
        "first_name": "SHANNAN",
        "middle_name": "KARLAYNE",
        "name_prefix": "Mrs.",
        "credential": "NPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-02-03",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "2139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0832",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Summerville, SC
• Providers in Summerville, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.