1. Home
  2. Directory
  3. South Carolina
  4. Columbia
  5. Family Medicine
  6. NPI Profile

DR. SHANE R MULL M.D.
NPI 1699786079
Family Medicine in Columbia, SC

Active since August 10, 2006PECOS Enrolled
3209 COLONIAL DR, USC- FAMILY & PREVENTIVE MEDICINE, COLUMBIA, SC 29203(803) 434-6113(803) 434-7231 Get Directions Write a Review

NPPES record last updated: March 26, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Shane R Mull M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANE R MULL M.D. (NPI 1699786079) is an individual family medicine provider in Columbia, South Carolina, licensed in South Carolina (23962) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699786079
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANE R MULLCredential: M.D.
Location Address3209 COLONIAL DR, USC- FAMILY & PREVENTIVE MEDICINEColumbia, SC 29203-6930
Mailing Address234 Westlake Farms DrBlythewood, SC 29016-8325 · (803) 917-9333
Phone(803) 434-6113
Fax(803) 434-7231
Sole ProprietorNo
Enumeration DateAugust 10, 2006
Last NPPES UpdateMarch 26, 2015
✔ NPI 1699786079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in SC · 23962✔ Licensed in NC · 2009-01329
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 23962 (SC)
3209 COLONIAL DR, Columbia, SC 29203
Open in Google Maps ↗

Other Identifiers 8

Medicare PINAA05962353SC
Medicare PINAA05696125SC
Medicare PINAA05696201SC
Medicare PINAA05696126SC
Medicare PINAA05697136SC
MedicaidLL4378SC
Medicare PINAA05694713SC
Medicare PINAA05692461SC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shane R Mull M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shane Mull reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medcare Urgent Care Center - Anderson LLC
98 mi
Urgent Care
801 N FANT ST
Anderson, SC 29621
  • Reassigned Medicare billing, South Carolina enrollment
  • Medicare enrollment name: Medcare Express - North Charleston LLC
  • 113 clinicians in this Medicare group
NPI 1689004095 (843) 793-6093

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES JOSEPH CARTER JR. M.D.
Family Medicine
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-6113
ERIN RENAE JONES NP
Nurse Practitioner (Family)
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 466-4323
KRISTIAN JORGENSEN DO
Family Medicine
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-7399
KAITLIN RESTREPO
Family Medicine
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-2420
DR. JUDE OKECHUKWU ONUOHA MD
Preventive Medicine (Public Health & General Preventive Medicine)
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-7399
IVORIE STANLEY MD
Preventive Medicine (Occupational Medicine)
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-6113
DR. TIMOTHY MYLES AYER MD
Family Medicine
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (803) 434-6113
DYNE EDMONDSON
Student in an Organized Health Care Education/Training Program
3209 COLONIAL DR
COLUMBIA, SC 29203
Richland County (989) 439-4847

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Mull's NPI number?

The NPI number for Shane Mull is 1699786079. It was assigned to this individual provider in the NPPES registry on August 10, 2006.

Where is Shane Mull located?

Shane Mull practices at 3209 Colonial Dr Usc- Family & Preventive Medicine, Columbia, SC 29203. The listed phone number is (803) 434-6113.

What is Shane Mull's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shane Mull enrolled in Medicare?

Yes. Shane Mull is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shane Mull's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Mull reassigns Medicare benefits to Medcare Urgent Care Center - Anderson LLC (Anderson, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Mull's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shane Mull was last updated on March 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.