Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Wilson

Individual provider Emergency Medicine Physician · NPI 1659121952

Shane Wilson is an Emergency Medicine in Columbia, South Carolina. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in South Carolina.

Years since qualifying
2
Licensed in
SC
In the registry since
2024

Practice location Address checks out

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone: (803) 434-1663
Fax: (803) 434-7092
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 92795 (SC)

Record details

NPI number1659121952
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 27, 2024
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Columbia