1. Home
  2. Directory
  3. South Carolina
  4. Loris
  5. Family Medicine
  6. NPI Profile

DR. SHANNON SMITH TIEBOUT DO
NPI 1205488848
Family Medicine in Loris, SC

Active since July 14, 2019PECOS EnrolledAccepts Medicare Assignment
3418 CASEY ST, LORIS, SC 29569(843) 756-7885(843) 756-7855 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Shannon Smith Tiebout Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANNON SMITH TIEBOUT DO (NPI 1205488848) is an individual family medicine provider in Loris, South Carolina, licensed in South Carolina (82954) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS, is affiliated with Mcleod Regional Medical Center-pee Dee, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205488848
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANNON SMITH TIEBOUTCredential: DO
Location Address3418 CASEY STLoris, SC 29569-2904
Mailing Address3418 Casey StLoris, SC 29569-2904 · (843) 756-7885
Phone(843) 756-7885
Fax(843) 756-7855
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJuly 14, 2019
Last NPPES UpdateDecember 19, 2023
NPPES CertifiedJuly 14, 2022
✔ NPI 1205488848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 82954
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3418 CASEY ST, Loris, SC 29569
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shannon Smith Tiebout Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224465042
PECOS Enrollment IDI20220802000444
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
279 services141 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
67 services67 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
65 services47 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
63 services49 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
19 services15 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mcleod Regional Medical Center-Pee Dee

Acute Care Hospitals · Florence, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420051
Location555 E Cheves St Box 8700Florence, SC 29506 · Florence County
Emergency services Birthing friendly

Mcleod Loris Hospital

Acute Care Hospitals · Loris, SC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420105
Location3655 Mitchell StreetLoris, SC 29569 · Horry County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29569 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MCLEOD PHYSICIAN ASSOCIATES II
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
SOUTHERN MEDICAL ASSOCIATES, P.A.
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
ANDREW J.R. SEJAN M.D.
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
MRS. JULIA BATTEN HUCKS FNP-C
Nurse Practitioner
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
LORIS COMMUNITY HOSPITAL DISTRICT
Internal Medicine (Critical Care Medicine)
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 716-7911
BRIAN JAMES THACKER DO
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885
LORIS COMMUNITY HOSPITAL DISTRICT
Family Medicine
3418 CASEY ST
LORIS, SC 29569
Horry County (843) 756-7885

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Tiebout's NPI number?

The NPI number for Shannon Tiebout is 1205488848. It was assigned to this individual provider in the NPPES registry on July 14, 2019.

Where is Shannon Tiebout located?

Shannon Tiebout practices at 3418 Casey St, Loris, SC 29569. The listed phone number is (843) 756-7885.

What is Shannon Tiebout's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shannon Tiebout enrolled in Medicare?

Yes. Shannon Tiebout is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shannon Tiebout accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, InStil Health and Molina Healthcare list Shannon Tiebout as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shannon Tiebout affiliated with any hospitals?

According to CMS data, Shannon Tiebout is affiliated with Mcleod Regional Medical Center-Pee Dee and Mcleod Loris Hospital.

When was this NPI record last updated?

The NPPES record for Shannon Tiebout was last updated on December 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.