Maryann Boland Shepard, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

12325 Issued in SC

Practice address

890 S Pleasantburg Dr
Greenville, SC 29607-2455

Phone

(864) 271-1450

Fax

(864) 271-3914

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1780628735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 S PLEASANTBURG DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072455",
            "telephone_number": "864-271-1450",
            "fax_number": "864-271-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "MARYANN",
        "middle_name": "BOLAND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "12325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "0225337",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123253",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4197855",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC ID",
            "identifier": "571004971003",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshepard7093@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mshepard7093@direct.ghs.myhfn.org",
            "address_1": "890 S Pleasantburg Dr",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296072455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy Shawn Shelton
• Sijie Joy Shen-Wagner, MD
• Lihong Shen, M.D.
• Zachary Sheorn, D.O.
• Dorothy Shepard, FNP
• Codie A Sheppard, PTA
• John D Sherbert, MD
• David Shane Sherbondy, M.D.
• Madison Taylor Sherbondy, MSN, APRN, FNP-C
• Morgan Alexis Sherbondy

• Pediatrics Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.