Individual provider Active NPI

Richard D Shrouds, MD

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1376651943
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23441 Issued in SC
Practice address
601 Clemson Rd
Columbia, SC 29229-4341
Phone
(803) 788-6146
Fax
(803) 462-0312
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23441 SC Primary

Addresses

Primary practice location

601 Clemson Rd
Columbia, SC 29229-4341

Mailing address

300 Rice Meadow Way Ste B
Columbia, SC 29229-8424
Phone (803) 788-6360

Other identifiers 1

IdentifierTypeStateIssuer
234411MedicaidSC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23441SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Pediatrics Alliance, LLC Past Accepting new patients

Organizations & group practices 1

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1376651943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RICE MEADOW WAY STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298424",
            "telephone_number": "803-788-6360",
            "fax_number": "803-462-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292294341",
            "telephone_number": "803-788-6146",
            "fax_number": "803-462-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROUDS",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "23441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234411",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.