Individual provider Active NPI

Gulanna Bernadette Vandross, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1245506047
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
17786 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-1436
Fax
(843) 402-1833
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 17786 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone (843) 572-1228

Other practice location 1

9263 Medical Plaza Dr Ste E
Charleston, SC 29406
Phone (843) 572-1228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000194 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173779006 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Anesthesia Associates, LLC CurrentSince Oct 1, 2021 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 8, 2023 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 8, 2023 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Prisma Health-Midlands CurrentSince Jun 30, 2012 Accepting new patients
Medical University Hospital Authority CurrentSince Sep 11, 2014 Accepting new patients
Prisma Health-Midlands CurrentSince Jun 30, 2012 Accepting new patients
Medical University Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Sep 11, 2014 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

1 Poston Rd
Ste 110
Charleston, SC 29407
Phone (843) 876-1347

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

423 Barony St
Moncks Corner, SC 29461

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

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.

Hospital & facility affiliations 2

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": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1245506047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9263 Medical Plaza Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29406",
            "country_code": "US",
            "telephone_number": "843-572-1228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDROSS",
        "first_name": "GULANNA",
        "middle_name": "BERNADETTE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "17786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.