Individual provider Active NPI

Rusty Ryan Creighton

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1396712402
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2625 Issued in SC
Practice address
Taylor at Marion Streets
Palmetto Health Baptist
Columbia, SC 29201
Phone
(803) 296-2548
Fax
(803) 296-2548
NPI assigned
Mar 7, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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 2625 SC Primary

Addresses

Primary practice location

Taylor at Marion Streets
Palmetto Health Baptist
Columbia, SC 29201

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other practice location 1

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Other identifiers 1

IdentifierTypeStateIssuer
AN1411MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050713000116 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678509437 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Carolina School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7 Independence PT
Suite 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2625SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients
Prisma Health-Midlands CurrentSince Jun 8, 2005 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Aiken Regional Medical Centers LLC Current Accepting new patients
Prisma Health-Midlands CurrentSince Jun 8, 2005 Accepting new patients
Aiken Regional Medical Centers, LLC. CurrentSince Jan 11, 2021 Accepting new patients
Aiken Regional Medical Centers LLC CurrentSince Jan 11, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

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

400 Palmetto Health Pkwy
Ste 2137
Columbia, SC 29212

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1396712402",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TAYLOR AT MARION STREETS",
            "address_2": "PALMETTO HEALTH BAPTIST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-296-2548",
            "fax_number": "803-296-2548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREIGHTON",
        "first_name": "RUSTY",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1411",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.