DR. COURTNEY W SHELBOURNE DMD
NPI 1407857428
Dentist - Oral and Maxillofacial Surgery in Charleston, SC

Active since August 02, 2005Opted out of Medicare · through Oct 26, 2027
198 RUTLEDGE AVE, SUITE 4, CHARLESTON, SC 29403(843) 853-5859(843) 853-5861 Get Directions Write a Review

NPPES record last updated: January 25, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Courtney W Shelbourne Dmd NPPES

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

DR. COURTNEY W SHELBOURNE DMD (NPI 1407857428) is an individual oral and maxillofacial surgery provider in Charleston, South Carolina, licensed in South Carolina (3426) and active in the NPI registry since August 2005. He has opted out of Medicare through October 26, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407857428
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. COURTNEY W SHELBOURNECredential: DMD
Location Address198 RUTLEDGE AVE, SUITE 4Charleston, SC 29403-5817
Mailing Address198 Rutledge Ave, Suite 4Charleston, SC 29403-5817 · (843) 853-5859 · Fax (843) 853-5861
Fax(843) 853-5861
Sole ProprietorYes
Enumeration DateAugust 2, 2005
Last NPPES UpdateJanuary 25, 2013
NPI 1407857428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in SC · 3426
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

198 RUTLEDGE AVE, Charleston, SC 29403

Other Identifiers 2

MedicaidZA9641SC
Medicare UPINU88909SC

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Courtney W Shelbourne Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 26, 2015 through October 26, 2027.

Opt-Out Effective DateOctober 26, 2015
Opt-Out In Effect ThroughOctober 26, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29403 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
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
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 10

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

Psychiatry & Neurology (Psychiatry)
198 RUTLEDGE AVE
CHARLESTON, SC 29403
Pediatrics
198 RUTLEDGE AVE, SUITE 1
CHARLESTON, SC 29403
Pediatrics
198 RUTLEDGE AVE, SUITE 1
CHARLESTON, SC 29403
Massage Therapist
198 RUTLEDGE AVE, STE 4
CHARLESTON, SC 29403
Psychologist (Clinical)
198 RUTLEDGE AVE
CHARLESTON, SC 29403
Dentist (Endodontics)
198 RUTLEDGE AVE, SUITE 3
CHARLESTON, SC 29403
Dentist
198 RUTLEDGE AVE, #3
CHARLESTON, SC 29403
Pediatrics
198 RUTLEDGE AVE, SUITE 1
CHARLESTON, SC 29403

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 Courtney Shelbourne's NPI number?

The NPI number for Courtney Shelbourne is 1407857428. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Courtney Shelbourne located?

Courtney Shelbourne practices at 198 Rutledge Ave Suite 4, Charleston, SC 29403. The listed phone number is (843) 853-5859.

What is Courtney Shelbourne's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Courtney Shelbourne enrolled in Medicare?

No. Courtney Shelbourne has opted out of Medicare through October 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Courtney Shelbourne accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 8 other insurers list Courtney Shelbourne 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.

When was this NPI record last updated?

The NPPES record for Courtney Shelbourne was last updated on January 25, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.