NPIMap

Organization Active NPI

Ether, LLC

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1003213174
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ETHER, LLC
Practice address
1070 Wildwood Centre Dr
Columbia, SC 29229-8420
Phone
(803) 788-1100
Fax
(803) 788-4522
NPI assigned
Dec 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Authorized official

Name
Mrs. Karla G Shreve
Title
Manager
Phone
(803) 788-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X SC Primary

Addresses

Primary practice location

1070 Wildwood Centre Dr
Columbia, SC 29229-8420

Mailing address

1070 Wildwood Centre Dr
Columbia, SC 29229-8420
Phone (803) 788-1100

Other identifiers 1

IdentifierTypeStateIssuer
GP6725MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1003213174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 WILDWOOD CENTRE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298420",
            "telephone_number": "803-788-1100",
            "fax_number": "803-788-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 WILDWOOD CENTRE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298420",
            "telephone_number": "803-788-1100",
            "fax_number": "803-788-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "SHREVE",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "803-788-1100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6725",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.