Individual provider Active NPI

Carol E. Pethel, CRNA

  • Certified Registered Nurse Anesthetist
  • Anderson, SC
National Provider Identifier
1215269147
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
083407 Issued in SC
Practice address
800 N Fant St
Anderson, SC 29621-5708
Phone
(864) 512-1340
Fax
(864) 512-1749
NPI assigned
Feb 3, 2010
Last updated
May 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 083407 SC Primary

Addresses

Primary practice location

800 N Fant St
Anderson, SC 29621-5708

Mailing address

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1417

Other identifiers 6

IdentifierTypeStateIssuer
NPI #OtherSCTRICARE (HUMANA)
NPI/SSNOtherSCBLUECROSS BLUESHIELD OF SC
P00911158OtherSCRAILROAD MEDICARE
AN2036MedicaidSC
NPI/SSNOtherSCBLUECHOICE OF SC
20101737OtherSCSELECT HEALTH OF SC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000083 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961538301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anmed HealthGroup PAC ID 1951215243, 348 clinicians

Practice addresses (Care Compare)

2000 E Greenville St
Anderson, SC 29621-1580
Phone (864) 512-3076

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Pathology Associates PA Current Accepting new patients
Anmed Health CurrentSince Feb 8, 2010 Accepting new patients
Anmed Health Nurse Anesthetist, Certified Registered CurrentSince Feb 8, 2010 Accepting new patients
Anmed Health Nurse Anesthetist, Certified Registered Current Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients

Locations

2000 E Greenville St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1215269147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1417",
            "fax_number": "864-512-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1340",
            "fax_number": "864-512-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETHEL",
        "first_name": "CAROL",
        "middle_name": "E.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "083407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE (HUMANA)",
            "identifier": "NPI #",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF SC",
            "identifier": "NPI/SSN",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00911158",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2036",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE OF SC",
            "identifier": "NPI/SSN",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH OF SC",
            "identifier": "20101737",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.