Kelly Elaine Shaffer, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

2008-02041 Issued in NC

Practice address

2687 Lake Park Dr
North Charleston, SC 29406-9100

Phone

(843) 572-1010

Fax

(843) 569-1719

NPI assigned

Oct 23, 2006

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

• Dr. Kelly Elaine Doyle 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Virginia Commonwealth University, School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lowcountry Urology Clinics, PAGroup PAC ID 6406869247, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
• Roper Hospital Hospital, Charleston, SC, CCN 420087
• Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Lowcountry Urology Clinics PA

  • Urology Physician
  • N Charleston, SC
  • NPI 1942242714
  Medicare reassignment Care Compare group NPD
• Lowcountry Urology Clinics, PA

  • Durable Medical Equipment & Medical Supplies
  • Charleston, SC
  • NPI 1831967454

  Urology

  NPD
• Lowcountry Urology Clinics, PA

  • Durable Medical Equipment & Medical Supplies
  • Charleston, SC
  • NPI 1790972685
  NPD (past)
• Stone Institute of the Carolinas LLC

  • Urology Physician
  • Davidson, NC
  • NPI 1457377954
  NPD (past)

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

• Bon Secours St. Francis Xavier Hospital Inc.

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation
• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation
• Roper St. Francis Mount Pleasant Hospital

  • General Acute Care Hospital
  • Mt Pleasant, SC
  • NPI 1255645644
  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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1710060017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643261",
            "telephone_number": "843-884-9646",
            "fax_number": "843-884-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-572-1010",
            "fax_number": "843-569-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "KELLY",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2008-02041",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "LL28461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "28461",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MED BOARD # 153519",
            "identifier": "273905550",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DOYLE",
            "middle_name": "ELAINE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Michelle Inez Shankland, PA-C
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• Urology Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.
• 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.