Individual provider Active NPI

Pamela K. Walker, CRNA

  • Certified Registered Nurse Anesthetist
  • Rock Hill, SC
National Provider Identifier
1396734828
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
72942 Issued in SC
Practice address
222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone
(803) 329-6711
Fax
(803) 329-5120
NPI assigned
Oct 18, 2005
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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 72942 SC Primary

Addresses

Primary practice location

222 S Herlong Ave
Rock Hill, SC 29732-1158

Mailing address

PO Box 2974
Rock Hill, SC 29732-4974
Phone (803) 985-4551

Other identifiers 2

IdentifierTypeStateIssuer
A9408OtherMEDCOST
AN0714MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72942SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. CurrentSince Jan 9, 2024 Accepting new patients
Anesthesia Associates of Rock Hill, P.a. CurrentSince Nov 17, 1997 Accepting new patients
Carolina Hyperbaric and Consultation Services LLC Past Accepting new patients

Locations

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1396734828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2974",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297324974",
            "telephone_number": "803-985-4551",
            "fax_number": "803-985-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-329-6711",
            "fax_number": "803-329-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "PAMELA",
        "middle_name": "K.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "72942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A9408",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0714",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.