Shannon Buck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5250 Issued in SC

Practice address

1101 Old Trolley Rd Ste 300
Summerville, SC 29485-5294

Phone

(843) 376-2670

NPI assigned

Jun 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PPCP Specialty Physicians , LLCGroup PAC ID 2466723028, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.buck@ppcp1.eclinicaldirectplus.com

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.

• PPCP Specialty Physicians , LLC

  • Gastroenterology Physician
  • Goose Creek, SC
  • NPI 1780123984
  Medicare reassignment Care Compare group NPD
• PPCP Specialty Physicians , LLC

  • Gastroenterology Physician
  • Charleston, SC
  • NPI 1093585044
  NPD
• PPCP Specialty Physicians , LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Summerville, SC
  • NPI 1841739968
  NPD

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

• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation
• Trident Medical Center, LLC

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1497598965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OLD TROLLEY RD STE 300",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855294",
            "telephone_number": "843-376-2670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "669 Marina Dr Ste A2",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294927573",
            "country_code": "US",
            "telephone_number": "843-491-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-07-21",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8121PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendra Johnson Bryant
• Michele Acejo Bucayan, PT
• Peter J Buccellato
• John Marshall Buck III, RPH
• Mackenzie Paige Buck, DC
• Elizabeth Buckley, DMD
• Building Independence Together
• Alison Paige Bull, P.A.
• Rob Bullard
• Bulldog Commercial Construction, LLC

• Physician Assistant in Summerville, SC
• Providers in Summerville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.