Individual provider Active NPI

Shelby Lee Williams, DPT

  • Physical Therapist
  • Inman, SC
National Provider Identifier
1063980100
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9454 Issued in SC
Practice address
13021 Asheville Hwy
Inman, SC 29349-7687
Phone
(864) 416-1289
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X P21175 NC
Physical Therapist 225100000X 9454 SC Primary

Addresses

Primary practice location

13021 Asheville Hwy
Inman, SC 29349-7687

Mailing address

60 Shuford Rd
Columbus, NC 28722-7406
Phone (828) 894-0277

Other practice location 1

60 Shuford Rd
Columbus, NC 28722-7406
Phone (828) 894-0277

Other practice location 2

1109 E Rutherford St
Ste A
Landrum, SC 29356
Phone (864) 457-1077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190128002941 SC Practitioner - Physical Therapist in Private Practice 4880931989 Reassigns benefits to 1 organization
I20220917000195 NC Practitioner - Physical Therapist in Private Practice 4880931989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9454SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Physical Therapy, Inc. Physical Therapist CurrentSince Jun 16, 2022 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

60 Shuford Rd
Columbus, NC 28722
Phone (828) 894-0277

1109 E Rutherford St
#A
Landrum, SC 29356
Phone (864) 457-1077

535 Laurens Rd
Woodruff, SC 29388
Phone (864) 476-6600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1063980100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SHUFORD RD",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287227406",
            "telephone_number": "828-894-0277",
            "fax_number": "828-894-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13021 ASHEVILLE HWY",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293497687",
            "telephone_number": "864-416-1289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Shuford Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "NC",
            "postal_code": "287227406",
            "country_code": "US",
            "telephone_number": "828-894-0277",
            "fax_number": "828-894-0278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1109 E Rutherford St",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Landrum",
            "state": "SC",
            "postal_code": "29356",
            "country_code": "US",
            "telephone_number": "864-457-1077",
            "fax_number": "864-457-1079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHELBY",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-08-01",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21175",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inman, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.