Individual provider Active NPI

Shiny Teja Kolli, MD

  • Internal Medicine Physician
  • Albany, GA
National Provider Identifier
1730854159
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
103408 Issued in GA
Practice address
417 W 3Rd Ave
Albany, GA 31701-1943
Phone
(229) 312-1414
NPI assigned
Aug 9, 2021
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 103408 GA Primary

Addresses

Primary practice location

417 W 3Rd Ave
Albany, GA 31701-1943

Mailing address

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250428003118 GA Practitioner - Internal Medicine 6002332590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

151 Mayo St
Suite B
Americus, GA 31709-4782
Phone (229) 928-2900

151 Mayo St a
Americus, GA 31709-4782
Phone (229) 312-5800

151 Mayo St C
Americus, GA 31709-4782
Phone (229) 928-2882

151 Mayo St D
Americus, GA 31709-4782
Phone (229) 928-1100

151 Mayo St E
Americus, GA 31709-4782
Phone (229) 931-1159

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-5222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103408GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Mar 1, 2025 Accepting new patients
Phoebe Putney Memorial Hospital Inc Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

Organizations & group practices 2

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": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1730854159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLI",
        "first_name": "SHINY TEJA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "103408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.