Active NPI
Lindsey Clendenin Kutlick, R.N
- Certified Registered Nurse Anesthetist
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 202417
- Practice address
- 1000 Blythe Blvd
Charlotte, NC 28203-5812 - Phone
- (704) 355-2000
- NPI assigned
- Dec 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 202417 | NC | |
| Certified Registered Nurse Anesthetist | 367500000X | 202417 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
Charlotte, NC 28203-5812
Mailing address
5201 Jupiter Hills CT
Charlotte, NC 28277-2513
Phone (704) 877-7760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
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)
1962 Charlie Hall Blvd
Charleston, SC 29414-5837
Phone (843) 722-8000
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours St. Francis Xavier Hospital, Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Atlantic Coast Anesthesia Services P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Bon Secours St Francis Xavier Hospital, Inc. | Current | Accepting new patients | |
| Coastal Anesthesia Associates, LLC | Current | Accepting new patients | |
| Charleston Gastroenterology Specialists | Current | Accepting new patients | |
| Bon Secours St. Francis Xavier Hospital, Inc. | Current | Accepting new patients | |
| Charleston Gastroenterology Specialists | Current | Accepting new patients |
Locations
2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037
1962 Charlie Hall Blvd
Charleston, SC 29414
Phone (803) 722-8000
423 Barony St
Moncks Corner, SC 29461
1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885
130 Edge St
Summerville, SC 29486
Phone (843) 628-5816
2001 2nd Ave
Ste 101
Summerville, SC 29486
Phone (843) 722-8000
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.
-
- Specialist
- Charleston, SC
- NPI 1205835865
-
- Anesthesiology Physician
- Myrtle Beach, SC
- NPI 1932641313
Nurse Anesthetist, Certified Registered
-
- Cardiovascular Disease Physician
- Charleston, SC
- NPI 1740502822
-
- Anesthesiology Physician
- Charleston, SC
- NPI 1942252176
-
- Anesthesiology Physician
- Charleston, SC
- NPI 1871035956
Nurse Anesthetist, Certified Registered
-
- Pediatrics Physician
- Charleston, SC
- NPI 1982583068
-
- Anesthesiology Physician
- Charleston, SC
- NPI 1194231761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1104129535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 JUPITER HILLS CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282772513",
"telephone_number": "704-877-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUTLICK",
"first_name": "LINDSEY",
"middle_name": "CLENDENIN",
"credential": "R.N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-07",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "202417",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "202417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.