Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Thomas David Shelburne III, PA-C

Individual provider Physician Assistant · NPI 1811764467

Mr. Thomas David Shelburne III, PA-C is a Physician Assistant in Columbia, South Carolina. Qualified in 2023, 3 years ago. Practices with Advanced Dermatology of SC PC, a 34-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
3
Licensed in
SC
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

610 Columbiana Dr
Columbia, SC 29212-0728
Phone: (803) 902-6568
Fax: (803) 902-6570
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3574 Sunset Blvd, West Columbia, SC 29169-3044 — (803) 796-2500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5178 (SC)

Record details

NPI number1811764467
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 5, 2023
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Advanced Dermatology Of Sc Pc — 34 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Columbia