Individual provider Active NPI

Susan Driver Holum

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1346543113
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95948 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-8908
Phone
(843) 792-1414
NPI assigned
Dec 16, 2010
Last updated
Oct 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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 95948 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8908

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110418000376 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931383858 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Wren Anesthesia Services LLCGroup PAC ID 4183153976, 32 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 881-0100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as group
Quality
83.18
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95948SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Wren Anesthesia Services, LLC CurrentSince Dec 15, 2024 Accepting new patients
Medical University Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2016 Accepting new patients
Medical University Hospital Authority CurrentSince Oct 13, 2016 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2017 Accepting new patients
Apollomd Group Services, LLC Past Accepting new patients

Locations

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

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

1106 Chuck Dawley Blvd
Ste 100
Mt Pleasant, SC 29464
Phone (843) 245-9498

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

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 6

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": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1346543113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUM",
        "first_name": "SUSAN",
        "middle_name": "DRIVER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "95948",
            "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 Oct 19, 2016; 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.