Carlton Brooks Shealy III, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

237093 Issued in SC

Practice address

420 Pavilion Pass
Aiken, SC 29803

Phone

(803) 257-0894

NPI assigned

Oct 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Carolina Nuclear Group, LLC

  • Home Health Agency
  • Aiken, SC
  • NPI 1710708599
  NPD Authorized official

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1316768112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIDING RIDGE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298010686",
            "telephone_number": "803-257-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PAVILION PASS",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29803",
            "telephone_number": "803-257-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEALY",
        "first_name": "CARLTON",
        "middle_name": "BROOKS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "SC",
            "license": "237093",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "SC",
            "license": "237093",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "237093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J Shannon, MD
• Idris Sayed Sharaf, M.D.
• Tayyaba Shaukat, MD
• Katrena Shaw
• Sandra F Shealey
• Sara T Shealy, RN
• Gerald W Sheets, BC/HIS
• Henna Shaheen Sheikh, OTRL
• Latrice Janiva Shell
• Lexington R Shelley Jr., DMD

• Registered Nurse in Aiken, SC
• Providers in Aiken, SC by specialty
• Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.