NPIMap

Organization Active NPI

Shelby Radiological Associates, PA

  • Diagnostic Radiology Physician
  • Shelby, NC
National Provider Identifier
1487633780
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
39419 Issued in NC
Legal business name
SHELBY RADIOLOGICAL ASSOCIATES, PA
Practice address
222 N Lafayette St
Suite 01
Shelby, NC 28150-4444
Phone
(704) 482-3880
Fax
(704) 487-0294
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Dr. Michael Douglas Wehmueller, MD
Title
Corporate Secretary
Phone
(704) 482-3880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 39419 NC Primary

Addresses

Primary practice location

222 N Lafayette St
Suite 01
Shelby, NC 28150-4444

Mailing address

222 N Lafayette St
Suite 01
Shelby, NC 28150-4444
Phone (704) 482-3880

Other identifiers 4

IdentifierTypeStateIssuer
020837299OtherUS DEPARTMENT OF LABOR
148760XXOtherPREFERRED CARE
8902663MedicaidNC
E16337MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160311000149 SC Part B Supplier - Clinic/Group Practice 3779479159 Receives reassigned benefits from 3 practitioners
Practice locations: Charleston, SC; Columbia, SC; Greenville, SC; Isle of Palms, SC; Sullivans Island, SC

National Provider Directory

National Provider Directory

Locations

222 N Lafayette St
Ste 1
Shelby, NC 28150

3620 Pelham Rd
#149
Greenville, SC 29615

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1487633780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N LAFAYETTE ST",
            "address_2": "SUITE 01",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504444",
            "telephone_number": "704-482-3880",
            "fax_number": "704-487-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N LAFAYETTE ST",
            "address_2": "SUITE 01",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504444",
            "telephone_number": "704-482-3880",
            "fax_number": "704-487-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY RADIOLOGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "WEHMUELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "704-482-3880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "39419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "020837299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "148760XX",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902663",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E16337",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.