NPIMap

Individual provider Active NPI

Shelaila N Villamor, DO

  • Family Medicine Physician
  • York, SC
National Provider Identifier
1316945710
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0738 Issued in SC
Practice address
1023 Creekside Medical Dr
York, SC 29745-8624
Phone
(803) 684-3738
Fax
(803) 684-3808
NPI assigned
Jul 9, 2005
Last updated
Jun 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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 0738 SC Primary

Addresses

Primary practice location

1023 Creekside Medical Dr
York, SC 29745-8624

Mailing address

1023 Creekside Medical Dr
York, SC 29745-8624
Phone (803) 684-3738

Other identifiers 1

IdentifierTypeStateIssuer
007389MedicaidSC

Other names 1

  • Dr. Shelaila Nadal Neri Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000951 SC Practitioner - Family Practice 9638065154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

1023 Creekside Medical Dr
York, SC 29745-8624
Phone (803) 684-3730

200 Herlong Ave S
Rock Hill, SC 29732-1182

207 Church St
Clover, SC 29710-1008
Phone (803) 222-3063

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0738SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Family Medicine CurrentSince Oct 23, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Piedmont East Urgent Care Center LLC PastSince Sep 3, 2013 Accepting new patients
Chicot Memorial Hospital Past Accepting new patients
Mainline Health Systems, Inc Past Accepting new patients
Piedmont Urgent Care Center at Baxter Village LLC Past Accepting new patients

Locations

207 Church St
Clover, SC 29710
Phone (803) 222-3063

1690 Highway 160 W
Fort Mill, SC 29708
Phone (803) 547-7541

502 6th Baxter Xing
Fort Mill, SC 29708
Phone (803) 396-8100

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

760 Addison Dr
Rock Hill, SC 29730
Phone (803) 329-1930

1023 Creekside Medical Dr
York, SC 29745
Phone (803) 684-3730

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • Direct secure messaging: shelaila.villamor.1@14929.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1316945710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 CREEKSIDE MEDICAL DR",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297458624",
            "telephone_number": "803-684-3738",
            "fax_number": "803-684-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 CREEKSIDE MEDICAL DR",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297458624",
            "telephone_number": "803-684-3738",
            "fax_number": "803-684-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAMOR",
        "first_name": "SHELAILA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-09",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "0738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007389",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELAILA",
            "last_name": "NERI",
            "middle_name": "NADAL",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, SC

Sources for this page

Verify at the official NPI Registry.