Individual provider Active NPI

Leslie Sykes Ancrum, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1417289596
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4094 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 792-1414
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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 4094 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

2915 Cathedral Lane
Charleston, SC 29414
Phone (843) 670-5008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000383 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547391252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical University Hospital AuthorityGroup PAC ID 1557268950, 218 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

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
4094SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University Hospital Authority CurrentSince Jan 14, 2010 Accepting new patients
Medical University Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2010 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

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.

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1417289596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 CATHEDRAL LANE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-670-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCRUM",
        "first_name": "LESLIE",
        "middle_name": "SYKES",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "4094",
            "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 Apr 23, 2012; 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.