Individual provider Active NPI

Sheria Amanuel

  • Contractor
  • Charleston, SC
National Provider Identifier
1104720671
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
10036745 Issued in SC
Practice address
1964 Ashley River Rd Ste B2
Charleston, SC 29407-4782
Phone
(803) 833-9060
NPI assigned
Oct 7, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 10036745 SC Primary

Addresses

Primary practice location

1964 Ashley River Rd Ste B2
Charleston, SC 29407-4782

Mailing address

48 Abdullah LN
Seabrook, SC 29940-3664
Phone (803) 833-9060

Other identifiers 1

IdentifierTypeStateIssuer
872284486MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10036745SCMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1104720671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ABDULLAH LN",
            "city": "SEABROOK",
            "state": "SC",
            "postal_code": "299403664",
            "telephone_number": "803-833-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 ASHLEY RIVER RD STE B2",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074782",
            "telephone_number": "803-833-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMANUEL",
        "first_name": "SHERIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "SC",
            "license": "10036745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872284486",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.