NPIMap

Individual provider Active NPI

James Loran Shrouder III, MD

  • Family Medicine Physician
  • Simpsonville, SC
National Provider Identifier
1972865384
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34546 Issued in SC
Practice address
404 SE Main St
Simpsonville, SC 29681-2652
Phone
(864) 228-1168
Fax
(864) 228-1169
NPI assigned
Jun 12, 2012
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME143399 FL
Family Medicine Physician 207Q00000X 34546 SC Primary

Addresses

Primary practice location

404 SE Main St
Simpsonville, SC 29681-2652

Mailing address

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 826-3469

Other practice location 1

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 826-3469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918001231 SC Practitioner - Family Practice 6305096116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Physician Services IncGroup PAC ID 6608826821, 106 clinicians

Practice addresses (Care Compare)

103 Fairview Pointe Dr
Simpsonville, SC 29681-3223
Phone (864) 967-4982

1200 Brookfield Blvd
Suite 400B
Greenville, SC 29607-6583
Phone (864) 605-3721

404 SE Main St
Simpsonville, SC 29681-2652
Phone (864) 228-1168

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34546SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc Family Medicine CurrentSince Sep 26, 2021 Accepting new patients
St Francis Physician Services Inc Family Medicine CurrentSince Sep 26, 2021 Accepting new patients
St Francis Physician Services Inc Family Medicine Past Accepting new patients

Locations

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

404 SE Main St
Simpsonville, SC 29681
Phone (864) 228-1168

Interoperability endpoints

  • Direct secure messaging: jshrouder1155708@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1972865384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 SE MAIN ST",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812652",
            "telephone_number": "864-228-1168",
            "fax_number": "864-228-1169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865776",
            "country_code": "US",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHROUDER",
        "first_name": "JAMES",
        "middle_name": "LORAN",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME143399",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "34546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.