DR. CARL B SHEALY MD
NPI 1861467235
Internal Medicine - Nephrology in Columbia, SC

Q: What is Carl Shealy's NPI number?

The NPI number for Carl Shealy is 1861467235. It was assigned to this individual provider in the NPPES registry on February 21, 2006.

Q: What is Carl Shealy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Carl Shealy was last updated on November 2, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since February 21, 2006PECOS EnrolledAccepts Medicare Assignment

23.96/100

CMS Quality Rating

121 PARK CENTRAL DR, 200, COLUMBIA, SC 29203(803) 252-9907(803) 252-9906 Get Directions Write a Review

NPPES record last updated: November 2, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 2, 2017, Aug 31, 2017 (2 updates tracked since 2017).

On this page

About Dr. Carl B Shealy Md NPPES

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

DR. CARL B SHEALY MD (NPI 1861467235) is an individual nephrology provider in Columbia, South Carolina, licensed in South Carolina (23581) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Prisma Health Richland Hospital, and is a graduate of Medical University Of South Carolina College Of Medicine (1997).

NPPES Registry Identity

NPI1861467235

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. CARL B SHEALYCredential: MD

Location Address121 PARK CENTRAL DR, 200Columbia, SC 29203-6469

Mailing Address121 Park Central Dr, 200Columbia, SC 29203-6469 · (803) 252-9907 · Fax (803) 252-9906

Phone(803) 252-9907

Fax(803) 252-9906

Sole ProprietorNo

Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 1997

Enumeration DateFebruary 21, 2006

Last NPPES UpdateNovember 2, 20172 updates tracked since enumeration

✔ NPI 1861467235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in SC · 23581

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

121 PARK CENTRAL DR, Columbia, SC 29203

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Other Identifiers 4

Medicare ID-Type Unspecified204012517SC

Medicaid235819SC

Medicare PINH125172040SC

Medicare UPINH12517SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Carl B Shealy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507900115

PECOS Enrollment IDI20100220000167

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.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

331 services157 patients

Kidney function blood test panel 80069

A kidney function blood test panel checks how well your kidneys are working. It measures levels of various substances in your blood, including proteins, electrolytes, and waste products. The results can help detect potential kidney issues early.

330 services203 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

313 services194 patients

Total protein level, urine 84156

The Total Protein Level in urine test measures the amount of protein present in your urine. This helps to check kidney health as high levels may indicate a problem. It's a simple, non-invasive procedure involving a urine sample.

296 services208 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

292 services207 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

287 services219 patients

Parathormone (parathyroid hormone) level 83970

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

231 services167 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

209 services29 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

173 services116 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

161 services82 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

124 services47 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

80 services79 patients

Iron level 83540

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

70 services45 patients

Iron binding capacity 83550

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

70 services45 patients

Ferritin (blood protein) level 82728

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

69 services45 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

54 services52 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

51 services49 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

41 services41 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

38 services32 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

33 services14 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

30 services17 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

21 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

13 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Prisma Health Richland Hospital

Acute Care Hospitals · Columbia, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420018

Location5 Medical ParkColumbia, SC 29203 · Richland County

Emergency services Birthing friendly

Musc Health Columbia Medical Center Downtown

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420026

Location2435 Forest DriveColumbia, SC 29204 · Richland County

Emergency services

Newberry County Memorial Hospital

Acute Care Hospitals · Newberry, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number420053

Location2669 Kinard St PO Box 497Newberry, SC 29108 · Newberry County

Emergency services Birthing friendly

Lexington Medical Center

Acute Care Hospitals · West Columbia, SC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420073

Location2720 Sunset BlvdWest Columbia, SC 29169 · Lexington County

Emergency services Birthing friendly

Prisma Health Baptist

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420086

Location1330 Taylor At Marion StColumbia, SC 29220 · Richland County

Emergency services Birthing friendly

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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

23.96/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Promoting Interoperability

Improvement Activities

Cost

79.86

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Other Providers at the Same Location NPPES 19

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

DR. PRAKASH N PRABHU MD

Internal Medicine (Nephrology)

121 PARK CENTRAL DR, 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

DR. NZISA L MUTINGA MD

Internal Medicine (Nephrology)

121 PARK CENTRAL DR, 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

PROF. STEPHANIE THOMPSON KIMBROUGH PA

Physician Assistant

121 PARK CENTRAL DR, 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

THOMAS S WHEELER MD

Internal Medicine (Nephrology)

121 PARK CENTRAL DR, SUITE 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

THOMAS BRIAN POWELL M.D.

Internal Medicine (Nephrology)

121 PARK CENTRAL DR, SUITE 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

PROF. CECIL J PARRIS PA

Physician Assistant

121 PARK CENTRAL DR, 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

SARAH ASHLEY FORD-SIGHTLER DNP

Nurse Practitioner (Acute Care)

121 PARK CENTRAL DR, SUITE 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

COLUMBIA NEPHROLOGY ASSOCIATES PA

Specialist

121 PARK CENTRAL DR, 200
COLUMBIA, SC 29203

Richland County (803) 252-9907

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 Carl Shealy's NPI number?

The NPI number for Carl Shealy is 1861467235. It was assigned to this individual provider in the NPPES registry on February 21, 2006.

Where is Carl Shealy located?

Carl Shealy practices at 121 Park Central Dr 200, Columbia, SC 29203. The listed phone number is (803) 252-9907.

What is Carl Shealy's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Carl Shealy enrolled in Medicare?

Yes. Carl Shealy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carl Shealy accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare and 1 other insurer list Carl Shealy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Shealy affiliated with any hospitals?

According to CMS data, Carl Shealy is affiliated with Prisma Health Richland Hospital, Musc Health Columbia Medical Center Downtown, Newberry County Memorial Hospital, Lexington Medical Center and Prisma Health Baptist.

When was this NPI record last updated?

The NPPES record for Carl Shealy was last updated on November 2, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.