Individual provider Active NPI

Kerin D. Harris, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1053371013
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
877 Issued in SC
Practice address
2435 Forest Drive
Columbia, SC 29204
Phone
(803) 454-2613
Fax
(803) 765-1732
NPI assigned
Mar 24, 2006
Last updated
Apr 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 877 SC Primary

Addresses

Primary practice location

2435 Forest Drive
Columbia, SC 29204

Mailing address

PO Box 1467
Columbia, SC 29202
Phone (803) 454-2613

Other identifiers 1

IdentifierTypeStateIssuer
AN1131MedicaidSC

Other names 1

  • Kerin D. Clayton Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011002602 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214085455 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince May 9, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Apr 1, 2019 Accepting new patients
Sisters of Charity Providence Hospitals Nurse Anesthetist, Certified Registered Past Accepting new patients
Branstiter Anesthesia Services, LLC Nurse Anesthetist, Certified Registered PastSince Oct 13, 2019 Accepting new patients
Cardiovascular Ansthesia, LLC Past Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

605 S Veterans Blvd
Glennville, GA 30427
Phone (912) 354-4800

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

4720 Waters Ave
Savannah, GA 31404
Phone (912) 350-4800

519 Stephenson Ave
Savannah, GA 31405

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1053371013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1467",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29202",
            "telephone_number": "803-454-2613",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-454-2613",
            "fax_number": "803-765-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KERIN",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1131",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERIN",
            "last_name": "CLAYTON",
            "middle_name": "D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.