Individual provider Active NPI

Nicole Marie Santavicca, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1336537034
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
25113 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
Fax
(864) 522-3705
NPI assigned
Jan 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9296779 FL
Critical Care Medicine Registered Nurse 163WC0200X RN643432 PA
Critical Care Medicine Registered Nurse 163WC0200X 0001228588 VA
Certified Registered Nurse Anesthetist 367500000X 106817 NC
Certified Registered Nurse Anesthetist 367500000X 25113 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150818003443 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931414133 Reassigns benefits to 2 organizations
I20210907002727 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931414133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians
Low Country Anesthesia, PAGroup PAC ID 8729063797, 62 clinicians

Practice addresses (Care Compare)

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 782-2000

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5224NCMDMental Health Counselor
RN9296779FLMDCritical Care Medicine Registered Nurse
RN643432PAMDCritical Care Medicine Registered Nurse
0001228588VAMDCritical Care Medicine Registered Nurse
106817NCMDCertified Registered Nurse Anesthetist
25113SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Sedation Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 9, 2015 Accepting new patients
Low Country Anesthesia, PA CurrentSince Jul 30, 2021 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 26, 2024 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 9, 2015 Accepting new patients

Locations

1505 SW Cary Pkwy
Ste 202
Cary, NC 27511
Phone (919) 249-5087

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

8300 Health Park
Ste 210
Raleigh, NC 27615
Phone (919) 249-5902

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2417 Atrium Dr
Ste 101
Raleigh, NC 27607
Phone (919) 249-5216

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

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

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

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

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 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": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1336537034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTAVICCA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-03",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9296779",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PA",
            "license": "RN643432",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "VA",
            "license": "0001228588",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "106817",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "25113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.