Asa Duncan Shirley III, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

1863 Issued in SC

Practice address

28 S Main St
Travelers Rest, SC 29690-1810

Phone

(864) 834-8001

Fax

(864) 834-5563

NPI assigned

Apr 11, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 21, 2016 through Mar 21, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Prime Dental, P.C.

  • Dentist
  • Travelers Rest, SC
  • NPI 1891856209
  NPD (past) Authorized official
• Trailhead Family Dentistry LLC

  • General Practice Dentistry
  • Travelers Rest, SC
  • NPI 1063829489
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1891918512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 S MAIN ST",
            "address_2": "P. O. BOX 987",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901810",
            "telephone_number": "864-834-8001",
            "fax_number": "864-834-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 S MAIN ST",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901810",
            "telephone_number": "864-834-8001",
            "fax_number": "864-834-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "ASA",
        "middle_name": "DUNCAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "1863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z18632",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Schneider Physical Therapy, LLC
• Margaret Schneider, P.T.
• Joanne Schumacher, RPH
• Brittany Lynn Seawright, FNP
• Misty Dawn Seay, REGISTERED PHARMACY
• Cortney Sims
• Kaitlin Sloop, DPT
• Andrea Cover Smith, MD
• Gwendolyn Rose Smith, DO
• Katie F Smith, PA-C

• Dentist in Travelers Rest, SC
• Providers in Travelers Rest, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.