Active NPI
Shawntoya Wilkerson
- Licensed Practical Nurse
- Kingstree, SC
National Provider Identifier
1386378917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 43195
- Practice address
- 342 W Main St
Kingstree, SC 29556-3235 - Phone
- (843) 355-3621
- Fax
- (843) 355-3624
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 43195 | SC | Primary |
Addresses
Primary practice location
342 W Main St
Kingstree, SC 29556-3235
Mailing address
342 W Main St
Kingstree, SC 29556-3235
Phone (843) 355-3621
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wilkerr@musc.edu | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43195 | SC | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1386378917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "342 W MAIN ST",
"city": "KINGSTREE",
"state": "SC",
"postal_code": "295563235",
"telephone_number": "843-355-3621",
"fax_number": "843-355-3624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "342 W MAIN ST",
"city": "KINGSTREE",
"state": "SC",
"postal_code": "295563235",
"telephone_number": "843-355-3621",
"fax_number": "843-355-3624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "SHAWNTOYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "SC",
"license": "43195",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "wilkerr@musc.edu",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "342 W Main St",
"city": "Kingstree",
"state": "SC",
"country_code": "US",
"postal_code": "295563235",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kingstree, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.