Active NPI
James Loran Shrouder III, MD
- Family Medicine Physician
- Simpsonville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34546
- Practice address
- 404 SE Main St
Simpsonville, SC 29681-2652 - Phone
- (864) 228-1168
- Fax
- (864) 228-1169
- NPI assigned
- Jun 12, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105894900 | Medicaid | FL | |
| 345460 | Medicaid | SC | |
| SC62915019 | Other | SC | MEDICARE PIN |
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: Yes
Enrollment records 1
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
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
- Interim Healthcare of the Upstate
- St Francis-Downtown
- Prisma Health Hillcrest Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Francis Physician Services Inc | Family Medicine | Current | Accepting new patients |
| St Francis Physician Services Inc | Family Medicine | Current | 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
- 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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Greenville, SC
- NPI 1871895771
Family Medicine
-
- Family Medicine Physician
- Greenville, SC
- NPI 1780912881
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295769438
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Greenville, SC
- NPI 1750897609
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1265988364
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1417505694
-
- General Acute Care Hospital
- Simpsonville, SC
- NPI 1447706569
-
- Sleep Disorder Diagnostic Clinic/Center
- Simpsonville, SC
- NPI 1982159877
Hospital
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1730123175
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1467496802
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1023418035
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1376899856
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105894900",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "345460",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SC62915019",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.