Pam Amanda Locke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R72682 Issued in SC

Practice address

606 Black River Rd
Georgetown, SC 29440-3304

Phone

(843) 240-8047

NPI assigned

May 26, 2006

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Musc Community PhysiciansGroup PAC ID 6507260668, shared by 9 NPIs, 1,353 clinicians

Tidelands Anesthesia Group LLCGroup PAC ID 5395258065, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
• Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Tidelands Anesthesia Group LLC

  • Anesthesiology Physician
  • Georgetown, SC
  • NPI 1144017781
  Medicare reassignment Care Compare group NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  Nurse Anesthetist, Certified Registered, SC

  Medicare reassignment NPD
• Coastal Healthcare Resources Inc

  • Anesthesiology Physician
  • Florence, SC
  • NPI 1467635128

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesia Network Services, LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1508199142
  NPD (past)

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

• Georgetown Memorial Hospital

  dba Tidelands Health Skilled Care

  • Skilled Nursing Facility
  • Georgetown, SC
  • NPI 1881307056

  Hospital

  Care Compare affiliation
• Georgetown Memorial Hospital

  dba Tidelands Georgetown Memorial Hospital

  • General Acute Care Hospital
  • Georgetown, SC
  • NPI 1982604021
  Care Compare affiliation
• Waccamaw Community Hospital

  dba Tidelands Waccamaw Community Hospital

  • General Acute Care Hospital
  • Murrells Inlet, SC
  • NPI 1972503910
  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1144276569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 LUMBEE CIR",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854391",
            "telephone_number": "438-240-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BLACK RIVER RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403304",
            "telephone_number": "843-240-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "PAM",
        "middle_name": "AMANDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "R72682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1322",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Denise Lewis, FNP
• Montrelle Latwan Lewis, PTA
• Lifeline Respiratory Services LLC (Lifeline Respiratory Services)
• Lindsay H Moore, DMD PA
• Michele Lively, APRN
• Margaret Elaine Loftin, M.A., LPC
• Ronald J Long, M.D.
• Look Eyecare LLC
• Haley Loptien, DO
• Timothy Menott Lordi, RPH

• Certified Registered Nurse Anesthetist in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.