Individual provider Active NPI

Patty Johnson Reis, CRNA

  • Certified Registered Nurse Anesthetist
  • Conway, SC
National Provider Identifier
1043458946
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3783 Issued in SC
Practice address
300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone
(843) 347-7111
NPI assigned
Jan 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3783 SC Primary

Addresses

Primary practice location

300 Singleton Ridge Rd
Conway, SC 29526-9142

Mailing address

2017 Lees Landing Cir
Conway, SC 29526-8046
Phone (843) 234-1064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000384 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486711108 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

4000 Hwy 9 E
Little River, SC 29566-7833
Phone (843) 777-7000

4000 Hwy 9 W
Suite 245
Little River, SC 29566-7833
Phone (843) 366-2940

800 E Cheves St
Florence, SC 29506-2650

Hospital & facility affiliations

  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Current Accepting new patients
McLeod Physician Associates II CurrentSince Jul 1, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Nov 26, 2018 Accepting new patients
McLeod Medical Center-Dillon Nurse Anesthetist, Certified Registered CurrentSince Feb 16, 2021 Accepting new patients
McLeod Physician Associates II CurrentSince Jul 1, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2018 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Feb 16, 2021 Accepting new patients

Locations

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1043458946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 LEES LANDING CIR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268046",
            "telephone_number": "843-234-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-347-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "PATTY",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "3783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.

Verify at the official NPI Registry.