Active NPI
Shad J Sutherland, RPH
- Pharmacist
- North Charleston, SC
National Provider Identifier
1336739663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44281
- Practice address
- 4412 Spruill Ave Ste C
North Charleston, SC 29405-4787 - Phone
- (843) 806-1299
- NPI assigned
- Jan 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 44281 | SC | Primary |
| Pharmacist | 183500000X | 018449 | KY |
Addresses
Primary practice location
4412 Spruill Ave Ste C
North Charleston, SC 29405-4787
Mailing address
4412 Spruill Ave Ste C
North Charleston, SC 29405-4787
Phone (404) 824-0187
Other practice location 1
1028 N Dixie Ave
Elizabethtown, KY 42701-2508
Phone (270) 982-0303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018449 | KY | MD | Pharmacist |
| 44281 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olde Time Pharmacy at Sixes LLC | Current | Accepting new patients | |
| Park Circle Pharmacy, LLC | Current | Accepting new patients | |
| Olde Time Pharmacy at Sixes, LLC | Current | Accepting new patients | |
| Apothecare Pharmacy of Elizabethtown P S C | Past | Accepting new patients |
Locations
4412 Spruill Ave
Ste C
North Charleston, SC 29405
Phone (843) 806-1299
Organizations & group practices 4
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.
-
- Community/Retail Pharmacy
- Holly Springs, GA
- NPI 1912208539
-
- Clinic/Center
- Holly Springs, GA
- NPI 1831476316
-
- Community/Retail Pharmacy
- North Charleston, SC
- NPI 1972233807
-
- Community/Retail Pharmacy
- Elizabethtown, KY
- NPI 1942341391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750377600000",
"number": "1336739663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4412 SPRUILL AVE STE C",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294054787",
"telephone_number": "404-824-0187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4412 SPRUILL AVE STE C",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294054787",
"telephone_number": "843-806-1299"
}
],
"practiceLocations": [
{
"address_1": "1028 N Dixie Ave",
"address_purpose": "LOCATION",
"city": "Elizabethtown",
"state": "KY",
"postal_code": "427012508",
"country_code": "US",
"telephone_number": "270-982-0303",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "SHAD",
"middle_name": "J",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-20",
"last_updated": "2025-06-20",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "44281",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "018449",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.