Individual provider Active NPI

Maria Nelson

  • Case Manager/Care Coordinator
  • Sumter, SC
National Provider Identifier
1417417619
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
208 W Hampton Ave
Sumter, SC 29150-4912
Phone
(803) 200-1046
Fax
(800) 790-3924
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

208 W Hampton Ave
Sumter, SC 29150-4912

Mailing address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone (803) 200-1046

Other practice location 1

1341 W Mockingbird Ln
Dallas, TX 75247-6913
Phone (803) 200-1046

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shooting Stars Early Intervention & Therapy Services LLC Current Accepting new patients

Locations

208 W Hampton Ave
Sumter, SC 29150
Phone (803) 200-1046

5900 Balcones Dr
Ste 100
Austin, TX 78731

1341 W Mockingbird Ln
Dallas, TX 75247
Phone (214) 217-7520

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1417417619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "803-200-1046",
            "fax_number": "800-790-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W HAMPTON AVE",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504912",
            "telephone_number": "803-200-1046",
            "fax_number": "800-790-3924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 W Mockingbird Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752476913",
            "country_code": "US",
            "telephone_number": "803-200-1046",
            "fax_number": "800-790-3924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.