SCOTTIE M SHELLEY (NPI# 1689948911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689948911 |
| Entity Type | Individual |
| Full Name | SCOTTIE M SHELLEY |
| Credential | NP |
| Practice Address |
2858 Sunset Blvd West Columbia SC 29169-3420 |
| Practice Telephone | 8036999073 |
| Practice Fax Number | 8665270937 |
| Mailing Telephone | 8036999073 |
| Mailing Fax Number | 8665270937 |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | 229989 | NC | Allopathic & Osteopathic Physicians |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
17720 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2858 SUNSET BLVD |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630020 | Keith Alexander Guest | Internal Medicine | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2005-06-27 |
| 1013557354 | Heather Shaw | Nurse Practitioner | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2020-01-15 |
| 1407402191 | Rachel Kelley | Social Worker | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2019-08-17 |
| 1851953574 | Yolanda Felita Boyd-gantt | Family Medicine | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2019-07-02 |
| 1699257196 | Janette Suzanne Street | Nurse Practitioner | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2018-08-30 |
| 1285040329 | Lavon Fenderson | Nurse Practitioner | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2014-07-09 |
| 1023155728 | Senior Health Associates, Pa | Internal Medicine | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2007-01-31 |
| 1891854873 | James O Williams Jr. | Family Medicine | 2858 Sunset Blvd, West Columbia, SC 29169-3420 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1831162304 | Lisa B Brannigan | Nurse Practitioner | 109 Midlands Ct, Ste A, West Columbia, SC 29169-3456 | 2006-02-07 |
| 1710536941 | Sarah Elizabeth Baldoni | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2019-09-10 |
| 1063070316 | Melanie Sue Scianna | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2019-06-02 |
| 1861058141 | Sonya M Neeley | Nurse Practitioner | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2019-05-13 |
| 1083187942 | Kaila Anne Young | Nurse Practitioner | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2019-01-03 |
| 1417447236 | Chineita Williams | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2018-05-16 |
| 1568963387 | Kristi Lea Hewitt | Nurse Practitioner | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2018-02-27 |
| 1568997492 | Jodi Katherine Cockerham | Nurse Practitioner | 2836 Augusta Rd, West Columbia, SC 29170-3323 | 2017-04-28 |
| 1235511619 | Sarah Catterton | Nurse Practitioner | 146 N Hospital Dr, Suite 400, West Columbia, SC 29169-4800 | 2015-06-23 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
Please comment or provide details below to improve the information on SCOTTIE M SHELLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.