Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shannon Smith Tiebout, DO

Individual provider Family Medicine Physician · NPI 1205488848

Dr. Shannon Smith Tiebout, DO is a Family Practice in Loris, South Carolina. Qualified in 2015, 11 years ago. Practices with McLeod Regional Medical Center of the Pee Dee Inc, a 407-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
11
Licensed in
SC
In the registry since
2019
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3418 Casey St
Loris, SC 29569-2904
Phone: (843) 756-7885
Fax: (843) 756-7855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 853 N Church St Ste 510, Spartanburg, SC 29303-3077 — (864) 560-1558

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 82954 (SC)

Record details

NPI number1205488848
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 14, 2019
Last updated in NPPESDecember 19, 2023
Certification dateJuly 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesUROLOGY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice McLeod Regional Medical Center Of The Pee Dee Inc — 407 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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