Individual provider Active NPI

Ryann Shealy, MD

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1245034388
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL94532 Issued in SC
Practice address
3209 Colonial Dr
Columbia, SC 29203-6930
Phone
(803) 434-7399
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL94532 SC Primary

Addresses

Primary practice location

3209 Colonial Dr
Columbia, SC 29203-6930

Mailing address

3209 Colonial Dr
Columbia, SC 29203-6930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801000047 SC Order and Referring Only - Family PracticePractitioner - Family Practice 3173031143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1245034388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036930",
            "telephone_number": "803-434-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEALY",
        "first_name": "RYANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL94532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.