Organization Active NPI

Parkway Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Myrtle Beach, SC
National Provider Identifier
1265743280
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PARKWAY ANESTHESIA, LLC
Practice address
827 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 492-5679
NPI assigned
Jun 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Jeffery C. Wilt
Title
Owner/Member
Phone
(843) 492-5679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

827 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

PO Box 1547
Columbia, SC 29202-1547

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1265743280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292021547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-492-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WILT",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "843-492-5679"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.