NPIMap

Individual provider Active NPI

Marlon D Shelby, PA

  • Physician Assistant
  • Chester, SC
National Provider Identifier
1447313630
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
608 Issued in SC
Practice address
517 Doctors CT
Chester, SC 29706-8644
Phone
(803) 581-2800
Fax
(803) 581-4396
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 608 SC Primary

Addresses

Primary practice location

517 Doctors CT
Chester, SC 29706-8644

Mailing address

PO Box 603898
Charlotte, NC 28260-3898
Phone (803) 581-2800

Other identifiers 1

IdentifierTypeStateIssuer
104247MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001107 SC Practitioner - Physician Assistant 3375431422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical University Hospital AuthorityGroup PAC ID 1557268950, 218 clinicians

Practice addresses (Care Compare)

517 Doctors CT
Chester, SC 29706-8644
Phone (803) 581-2800

Hospital & facility affiliations

  • Neighbors Care Home Health Agency, an Amedisys Co Home health agency, Chester, SC, CCN 427063
  • Musc Health Chester Medical Center Hospital, Chester, SC, CCN 420019
  • Musc Health Lancaster Medical Center Hospital, Lancaster, SC, CCN 420036
  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as group
Quality
83.18
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
608SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University Hospital Authority CurrentSince Dec 1, 2020 Accepting new patients
Medical University Hospital Authority CurrentSince Dec 1, 2020 Accepting new patients
Carolina Family Care, Inc CurrentSince Mar 1, 2019 Accepting new patients
Carolina Family Care CurrentSince Mar 1, 2019 Accepting new patients
York Emergency Physicians Past Accepting new patients
Chester Hma Physician Management Inc Past Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

1 Medical Park Dr
#4A
Chester, SC 29706
Phone (803) 581-2001

517 Doctors Ct
Chester, SC 29706
Phone (803) 581-2800

517 Doctors Ct
Lowr
Chester, SC 29706
Phone (803) 581-2800

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

1600 Midtown Ave
Mt Pleasant, SC 29464
Phone (843) 284-6555

511 S Main St
Mullins, SC 29574
Phone (843) 464-8244

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1447313630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603898",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603898",
            "telephone_number": "803-581-2800",
            "fax_number": "803-581-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 DOCTORS CT",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297068644",
            "telephone_number": "803-581-2800",
            "fax_number": "803-581-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "MARLON",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104247",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, SC

Sources for this page

Verify at the official NPI Registry.