Shelley M Gilbert, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TL2725

Practice address

4301 Dick Pond Rd
Myrtle Beach, SC 29588-6807

Phone

(843) 652-8100

Fax

(843) 652-8122

NPI assigned

Dec 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Shelley M Burtt Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Georgetown Physician Associates, LLC

  dba Tidelands Health Family Medicine

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment
• Georgetown Physician Associates LLC

  dba Tidelands Health Group

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Georgetown Physician Associates, LLC

  dba Tidelands Health Family Medicine

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1780118414
  NPD
• Prime Care Physicians, P.L.L.C.

  • Cardiovascular Disease Physician
  • Albany, NY
  • NPI 1285627075

  Medical

  NPD (past)

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1467698621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295761209",
            "telephone_number": "843-652-8220",
            "fax_number": "843-520-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 DICK POND RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886807",
            "telephone_number": "843-652-8100",
            "fax_number": "843-652-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "SHELLEY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "TL2725",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "TL2725",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03160950",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "BURTT",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jevaughn Gibbs, OD
• Sean L. Gibbs, M.D.
• Troy Gibson
• Valda Gibson, M.D.
• Eugene M. Giddens, MD
• Griffin Gill
• Ginny Page Counseling, LLC
• Laura Glass, NP
• Lisa Marie Gleitmann, MD
• Mark Dwight Glenn, MD

• Medical Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.