Individual provider Active NPI

Mekesha Shaw, DNP

  • Family Nurse Practitioner
  • Florence, SC
National Provider Identifier
1922589704
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22188 Issued in SC
Practice address
1196 Waxwing Dr Unit a
Florence, SC 29505-3846
Phone
(999) 999-9999
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22188 SC Primary

Addresses

Primary practice location

1196 Waxwing Dr Unit a
Florence, SC 29505-3846

Mailing address

1196 Waxwing Dr Unit a
Florence, SC 29505-3846

Other identifiers 2

IdentifierTypeStateIssuer
NP7634MedicaidSC
SC6095OtherSCMEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210305001616 SC Practitioner - Nurse Practitioner 8527474139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Practice addresses (Care Compare)

1268 S 4TH St
Hartsville, SC 29550-0703
Phone (843) 332-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22188SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Physicians Services, LLC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
Caresouth Carolina, Inc. CurrentSince Jul 17, 2021 Accepting new patients
Pruitthealth Pharmacy Services, Inc. Past Accepting new patients

Locations

1268 S 4th St
Ste B
Hartsville, SC 29550

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

328 Riverchase Way
Lexington, SC 29072
Phone (803) 739-4949

Interoperability endpoints

  • Direct secure messaging: mekesha.shaw@csci.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1922589704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 WAXWING DR UNIT A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 WAXWING DR UNIT A",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295053846",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MEKESHA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7634",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SC6095",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.