Individual provider Active NPI

Amber Lynne Henderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1316054836
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21151 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-1436
Fax
(843) 402-1833
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 21151 SC Primary
Certified Registered Nurse Anesthetist 367500000X 52671 WV

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

PO Box 632509
Cincinnati, OH 45263-2508
Phone (803) 765-1838

Other practice location 1

65 Ringold Ln
Morgantown, WV 26508
Phone (304) 612-4662

Other identifiers 2

IdentifierTypeStateIssuer
2602523000MedicaidWV
AN2706MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171028000440 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799682019 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum AnesthesiaGroup PAC ID 9638326432, 65 clinicians
Low Country Anesthesia, PAGroup PAC ID 8729063797, 62 clinicians

Practice addresses (Care Compare)

40 Okatie Ctr Blvd S
Suite 125
Okatie, SC 29909-7510
Phone (843) 705-8804

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (800) 228-0249

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2017 Accepting new patients
Optimum Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Apr 8, 2025 Accepting new patients
Beach Anesthesia, LLC CurrentSince Apr 1, 2023 Accepting new patients
Low Country Anesthesia, PA CurrentSince Oct 9, 2017 Accepting new patients
Nurse Anesthesia of South Carolina LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients

Locations

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

1844 Wallace School Rd
Charleston, SC 29407
Phone (843) 556-2545

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

190 Pembroke Dr
Hilton Head Island, SC 29926
Phone (843) 682-2345

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

40 Okatie Center Blvd S
Ste 125
Okatie, SC 29909
Phone (843) 705-8804

Organizations & group practices 6

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1316054836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632509",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632508",
            "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": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Ringold Ln",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "26508",
            "country_code": "US",
            "telephone_number": "304-612-4662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "AMBER",
        "middle_name": "LYNNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "21151",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "52671",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2602523000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2706",
            "state": "SC"
        }
    ],
    "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 Jun 29, 2026; 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.