Susan Sheppard-Carolina

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

28125 Issued in SC

Practice address

102 S Merriman Rd
Georgetown, SC 29440-3459

Phone

(843) 833-8113

NPI assigned

Dec 4, 2023

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

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St James Health and Wellness IncGroup PAC ID 1658280334, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• St James Health and Wellness Inc

  • Federally Qualified Health Center (FQHC)
  • Georgetown, SC
  • NPI 1366568594
  Medicare reassignment Care Compare group NPD
• St James Health and Wellness Inc

  • Federally Qualified Health Center (FQHC)
  • MC Clellanville, SC
  • NPI 1588618441
  NPD
• St. James Health and Wellness Inc.

  • Federally Qualified Health Center (FQHC)
  • Georgetown, SC
  • NPI 1962250258
  NPD

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1972370641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 CORNER LOOP",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294405493",
            "telephone_number": "843-240-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S MERRIMAN RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403459",
            "telephone_number": "843-833-8113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "329 Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294401300",
            "country_code": "US",
            "telephone_number": "843-436-1213",
            "fax_number": "843-436-1214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD-CAROLINA",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "28125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Selander-Han, D.O.
• Serenity Dove Home Care, LLC
• Heather Denise Sharpe, PHARMD
• William A Shaver, M.D.
• Larry E. Sheehan, DMD
• Angela Carter Sheridan, FNP
• Sara Beth Shields Tarwater
• Cynthia L Shields, CRNA
• David Monroe Shipp Jr., PHARM.D
• Victor Sidhom, M.D.

• Primary Care Nurse Practitioner in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Primary Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.