Individual provider Active NPI

Melvin Stanaway, CRNA

  • Certified Registered Nurse Anesthetist
  • Orangeburg, SC
National Provider Identifier
1194780437
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1043 Issued in SC
Practice address
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 454-2613
Fax
(803) 765-1732
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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 1043 SC Primary

Addresses

Primary practice location

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 765-1838

Other identifiers 6

IdentifierTypeStateIssuer
576008010015OtherSCTRICARE
AN0006MedicaidSC
000000166668OtherSCUNISON
20018620OtherSCFIRST CHOICE
576008010006OtherSCBLUE CHOICE
576008010009OtherDEBCBS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15955SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orangeburg Anesthesia Associates, P.a. Past Accepting new patients

Organizations & group practices 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1194780437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "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": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-454-2613",
            "fax_number": "803-765-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANAWAY",
        "first_name": "MELVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "1043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "576008010015",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0006",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000166668",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "20018620",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "576008010006",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "576008010009",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.