Individual provider Active NPI

Kimberly Karla Matthews, CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, SC
National Provider Identifier
1114987823
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2095 Issued in SC
Practice address
555 E Cheves St
Florence, SC 29506-2617
Phone
(843) 777-8752
Fax
(843) 777-8705
NPI assigned
Mar 25, 2006
Last updated
Nov 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APN2095 SC
Certified Registered Nurse Anesthetist 367500000X 2095 SC Primary

Addresses

Primary practice location

555 E Cheves St
Florence, SC 29506-2617

Mailing address

3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 882-0705

Other identifiers 1

IdentifierTypeStateIssuer
AN1310MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040728001110 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113997024 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
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)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2095SCMDChiropractor
APN2095SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Center-Dillon CurrentSince May 1, 2012 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2004 Accepting new patients
Under Anesthesia CurrentSince Oct 30, 2012 Accepting new patients
Florence Surgery & Laser Center LLC CurrentSince May 30, 2011 Accepting new patients
Coastal Healthcare Resources Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2007 Accepting new patients
McLeod Physician Associates II CurrentSince Jun 1, 2021 Accepting new patients
Carolina Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince Feb 25, 2012 Accepting new patients
McLeod Medical Center-Dillon Nurse Anesthetist, Certified Registered CurrentSince May 1, 2012 Accepting new patients
McLeod Physician Associates II Current Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jun 7, 2004 Accepting new patients
Florence Surgery & Laser Center LLC CurrentSince May 30, 2011 Accepting new patients
McLeod Physician Associates II CurrentSince Jun 1, 2021 Accepting new patients
Lighthouse Anesthesiology of South Carolina, PA Past Accepting new patients
Pain Management, LLC Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Jay Godines, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

101 W 27th St
Lumberton, NC 28358
Phone (910) 739-0770

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

1204 E Cheves St
Florence, SC 29506
Phone (843) 673-0122

400 N Cashua Dr
Florence, SC 29501
Phone (843) 664-9398

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

700 S Parker Dr
Ste 7
Florence, SC 29501
Phone (843) 649-3251

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

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

5 Memorial Medical Ct
Greenville, SC 29605
Phone (864) 272-3409

500 Nelson Blvd
Kingstree, SC 29556
Phone (843) 354-9661

200 E Hospital St
Manning, SC 29102
Phone (803) 433-0439

3545 Highway 17
Murrells Inlt, SC 29576
Phone (843) 294-1941

101 Surgeons Dr
Myrtle Beach, SC 29579
Phone (803) 504-7194

420 W Wesmark Blvd
Sumter, SC 29150
Phone (803) 469-4402

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1114987823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD",
            "address_2": "SUITE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-882-0705",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "843-777-8752",
            "fax_number": "843-777-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KIMBERLY",
        "middle_name": "KARLA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-25",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "APN2095",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1310",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.