Individual provider Active NPI

John C Walthall, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1154321743
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
67298 Issued in SC
Practice address
1735 Taylor St
Columbia, SC 29201-3452
Phone
(803) 254-8449
NPI assigned
Jul 26, 2005
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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 67298 SC Primary

Addresses

Primary practice location

1735 Taylor St
Columbia, SC 29201-3452

Mailing address

148 Welchman Ave
Goose Creek, SC 29445-7152
Phone (843) 327-6616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031110000239 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628981347 Reassigns benefits to 5 organizations
I20150902001176 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628981347 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amsurg Columbia Anesthesia LLCGroup PAC ID 7315187788, 7 clinicians

Practice addresses (Care Compare)

2739 Laurel St
1B
Columbia, SC 29204-2028
Phone (803) 254-9588

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67298SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc Nurse Anesthetist, Certified Registered CurrentSince May 14, 2015 Accepting new patients
Amsurg Columbia Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 10, 2017 Accepting new patients
Beach Anesthesia, LLC CurrentSince Jan 1, 2023 Accepting new patients
Carolina Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2015 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince May 14, 2015 Accepting new patients
Carolina Regional Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2015 Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Trident Anesthesia Group, LLC Past Accepting new patients
Fairfield Memorial Hospital Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Colleton Medical Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Colleton Medical Hospitalists LLC Past Accepting new patients
Mobile Anesthesia, LLC Past Accepting new patients

Locations

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

1141 N Road St
#1
Elizabeth City, NC 27909
Phone (252) 338-0101

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

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

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

1920 Pickens St
Columbia, SC 29201
Phone (803) 254-7732

2631 Forest Dr
Columbia, SC 29204
Phone (803) 254-8449

2739 Laurel St
Ste 1B
Columbia, SC 29204
Phone (803) 254-9588

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

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

945 82nd Pkwy
Ste 2
Myrtle Beach, SC 29572
Phone (843) 839-0823

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

131 Summerplace Dr
West Columbia, SC 29169
Phone (803) 794-4585

Organizations & group practices 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1154321743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 WELCHMAN AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457152",
            "telephone_number": "843-327-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 TAYLOR ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013452",
            "telephone_number": "803-254-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTHALL",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "67298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 14, 2010; 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.