Active NPI
Paul Derek Street, CRNA
- Certified Registered Nurse Anesthetist
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- APRN4210
- Practice address
- 7 Independence PT Ste 300
Greenville, SC 29615-4569 - Phone
- (864) 522-3700
- Fax
- (864) 522-3705
- NPI assigned
- Jun 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | APRN4210 | SC | Primary |
Addresses
Primary practice location
7 Independence PT Ste 300
Greenville, SC 29615-4569
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other practice location 1
5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, FL
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
449 W 23Rd St
Panama City, FL 32405-4507
Phone (954) 939-5000
Hospital & facility affiliations
- HCA Florida Gulf Coast Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN4210 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Under Anesthesia | Current | Accepting new patients | |
| Anesthesia Physician Solutions of North Florida, LLC | Current | Accepting new patients | |
| Anesthesia Physician Solutions of North Florida, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Prisma Health-Midlands | Current | Accepting new patients | |
| Anesthesia Physician Solutions of North Florida, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Jay Godines, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610
449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900
325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000
106 Ellett Rd
Chapin, SC 29036
Phone (803) 941-8096
5 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-2168
1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137
5 Richland Medical Park Dr
Ste 470
Columbia, SC 29203
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
5 Memorial Medical Ct
Greenville, SC 29605
Phone (864) 272-3409
420 W Wesmark Blvd
Sumter, SC 29150
Phone (803) 469-4402
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Gainesville, FL
- NPI 1164932901
Nurse Anesthetist, Certified Registered
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1205889458
-
- Anesthesiology Physician
- Sumter, SC
- NPI 1194018242
-
- Anesthesiology Physician
- Pensacola, FL
- NPI 1831605617
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Kissimmee, FL
- NPI 1902478431
-
- Anesthesiology Physician
- Sumter, SC
- NPI 1831498559
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Panama City, FL
- NPI 1699721589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1003136862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 INDEPENDENCE PT STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154569",
"telephone_number": "864-522-3700",
"fax_number": "864-522-3705"
}
],
"practiceLocations": [
{
"address_1": "5 Richland Medical Park Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292036863",
"country_code": "US",
"telephone_number": "803-434-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STREET",
"first_name": "PAUL",
"middle_name": "DEREK",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "APRN4210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
- Stephen Strasberg, M.D.
- Denise H Strasser, APRN-BC
- Tarl Morgan Strasser, FNP
- Keith Wilson Strausbaugh Jr., DMD
- Keith Wilson Strausbaugh, DMD
- Deborah Kay Strickland, LISW-CP
- Jaime Hollingsworth Strickland, CRNA
- Lauren Ashley Strickland, ARNP, FNP-BC
- Roy E Strickland Jr., DDS
- Maria Evelyn Striebich, MS, CGC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.