James Welton Shealy, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

09480 Issued in IA

Practice address

16 Felton PL # B
Cartersville, GA 30120-2152

Phone

(770) 382-3536

Fax

(770) 382-1915

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 10

Addresses

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Dentistry for Children of South Carolina PC

  • Dentist
  • Hanahan, SC
  • NPI 1063901692
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1619044724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FELTON PL # B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202152",
            "telephone_number": "770-382-3536",
            "fax_number": "770-382-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FELTON PL # B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202152",
            "telephone_number": "770-382-3536",
            "fax_number": "770-382-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEALY",
        "first_name": "JAMES",
        "middle_name": "WELTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12013092A",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.025291",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901022957",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "8498",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "10380",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "36121",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "1001759",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN011369",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS042563",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "09480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS MEDICAID",
            "identifier": "100517",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL MEDICAID",
            "identifier": "9181146",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00746798B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Syed Muhammad Shan Ul Islam, MD
• Khalil NA'Im Sharif, M.D.
• Joseph M Sharp, DPT
• Devon Shay
• Gerard E Shea Jr., D.C.
• Brittany Deann Shelton, PA-C
• Lauren Rudell Shepard, FNP-C
• Sheridan Anesthesia Services of North Georgia, P.C
• Audrey Jordan Sherles, PT, DPT
• Scott Alan Sherwin, M.S.C.M.

• Pediatric Dentistry in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.