Individual provider Active NPI

Tammy Lawler Ivy, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Pleasant, SC
National Provider Identifier
1417086802
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
OR 96158. Issued in SC
Practice address
1375 Hospital Dr
Mt Pleasant, SC 29464-3254
Phone
(843) 883-5800
NPI assigned
Mar 3, 2007
Last updated
Oct 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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 OR 96158. SC Primary

Addresses

Primary practice location

1375 Hospital Dr
Mt Pleasant, SC 29464-3254

Mailing address

1728 W Canning Dr
Mt Pleasant, SC 29466-9311
Phone (843) 906-3276

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000357 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597926824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kershaw Anesthesia LLCGroup PAC ID 2567764384, 18 clinicians

Practice addresses (Care Compare)

1315 Roberts St
Camden, SC 29020-3737
Phone (803) 713-6376

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OR 96158.SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kershaw Anesthesia, LLC CurrentSince Sep 9, 2025 Accepting new patients
Bay Microsurgical Unit, Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients
Coastal Healthcare Resources Inc Nurse Anesthetist, Certified Registered CurrentSince May 12, 2025 Accepting new patients
Bay Microsurgical Unit, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Pain Management, LLC Past Accepting new patients
GT Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Carolina Anesthesiology Associates PA Past Accepting new patients
Carolina Anesthesiology Associates PA Past Accepting new patients

Locations

101 W 27th St
Lumberton, NC 28358
Phone (910) 739-0770

1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311

1200 Highmarket St
Ste 100
Georgetown, SC 29440
Phone (843) 546-8421

5 Memorial Medical Ct
Greenville, SC 29605
Phone (864) 272-3409

3545 Highway 17
Murrells Inlt, SC 29576
Phone (843) 294-1941

150 Village Center Blvd
Myrtle Beach, SC 29579
Phone (843) 449-7115

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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 1

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": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1417086802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W CANNING DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669311",
            "telephone_number": "843-906-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643254",
            "telephone_number": "843-883-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "TAMMY",
        "middle_name": "LAWLER",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "OR 96158.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.