Individual provider Active NPI

Shad J Sutherland, RPH

  • Pharmacist
  • North Charleston, SC
National Provider Identifier
1336739663
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44281 Issued in SC
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

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
018449KYMDPharmacist
44281SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Olde Time Pharmacy at Sixes LLC Current Accepting new patients
Park Circle Pharmacy, LLC CurrentSince Jun 23, 2025 Accepting new patients
Olde Time Pharmacy at Sixes, LLC Current Accepting new patients
Apothecare Pharmacy of Elizabethtown P S C PastSince Jan 1, 2021 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.

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.

Verify at the official NPI Registry.