Individual provider Active NPI

Leslie T Gaynor, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1417275876
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
042622 Issued in PA
Practice address
9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone
(843) 572-1228
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 042622 PA Primary

Addresses

Primary practice location

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112

Mailing address

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone (843) 572-1228

Other practice location 1

1200 Old York Rd
Abington, PA 19001-3720
Phone (215) 481-2000

Other identifiers 2

IdentifierTypeStateIssuer
25890OtherSCLICENSE
RN345306LOtherPALICENSE

Other names 1

  • Margaret L Gaynor Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100803000173 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840323481
I20240513003850 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840323481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042622PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Anesthesia Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients
Anesthesia Associates of Abington Past Accepting new patients

Locations

423 Barony St
Moncks Corner, SC 29461

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1417275876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Abington",
            "state": "PA",
            "postal_code": "190013720",
            "country_code": "US",
            "telephone_number": "215-481-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "LESLIE",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "042622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25890",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN345306L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "GAYNOR",
            "middle_name": "L",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.