Individual provider Active NPI

Kenneth C. Evec, CRNA

  • Certified Registered Nurse Anesthetist
  • Beaufort, SC
National Provider Identifier
1124095344
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1487 Issued in SC
Practice address
955 Ribaut Rd
Beaufort, SC 29902-5441
Phone
(803) 454-2600
Fax
(803) 765-1732
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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 1487 SC Primary

Addresses

Primary practice location

955 Ribaut Rd
Beaufort, SC 29902-5441

Mailing address

PO Box 1927
Columbia, SC 29202-1927
Phone (803) 765-1838

Other identifiers 1

IdentifierTypeStateIssuer
AN1107MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21139SCMDPediatric Emergency Medicine (Emergency Medicine) Physician
1487SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Anesthesia, PA CurrentSince Mar 1, 2017 Accepting new patients
Anesthesia Partners, LTD. Past Accepting new patients
Anesthesia Associates of Savannah ,PA Past Accepting new patients
St Johns Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients
Beaufort County Memorial Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
St John'S Regional Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

955 Ribaut Rd
#C
Beaufort, SC 29902

955 Ribaut Rd
#11
Beaufort, SC 29902
Phone (843) 522-5007

955 Ribaut Rd
Ste 11
Beaufort, SC 29902
Phone (843) 522-5746

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

190 Pembroke Dr
Hilton Head Island, SC 29926
Phone (843) 682-2345

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1124095344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1927",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292021927",
            "telephone_number": "803-765-1838",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "803-454-2600",
            "fax_number": "803-765-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVEC",
        "first_name": "KENNETH",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "1487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1107",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.