Individual provider Active NPI

Charity Marie Bukowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1447358999
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4178 Issued in SC
Practice address
1330 Taylor at Marion St
Columbia, SC 29210
Phone
(803) 296-5804
Fax
(803) 296-2548
NPI assigned
Sep 20, 2006
Last updated
Jun 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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 4178 SC Primary

Addresses

Primary practice location

1330 Taylor at Marion St
Columbia, SC 29210

Mailing address

1330 Taylor at Marion St
Columbia, SC 29210
Phone (803) 296-5804

Other identifiers 1

IdentifierTypeStateIssuer
100510764MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815002309 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002838661 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach Anesthesia, LLCGroup PAC ID 6103924014, 91 clinicians
Consultants in Gastroenterology PAGroup PAC ID 2769527480, 39 clinicians

Practice addresses (Care Compare)

109 Blarney Dr
Columbia, SC 29223-6244
Phone (803) 865-8200

131 Summerplace Dr
West Columbia, SC 29169-3058
Phone (803) 794-4585

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4178SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Gastroenterology PA CurrentSince Apr 27, 2015 Accepting new patients
Palmetto Endoscopy Suite, LLC CurrentSince Sep 14, 2015 Accepting new patients
John T Goodsell DO PC Gregory Linderer MD LTD PastSince Nov 18, 2009 Accepting new patients

Locations

11 Gateway Corners Park
Columbia, SC 29203
Phone (803) 462-2300

1520 Taylor St
Columbia, SC 29201
Phone (803) 254-8449

1520 Taylor St
Ste 250
Columbia, SC 29201
Phone (803) 509-5710

131 Summerplace Dr
West Columbia, SC 29169
Phone (803) 794-4585

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1447358999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 TAYLOR AT MARION ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29210",
            "telephone_number": "803-296-5804",
            "fax_number": "803-296-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 TAYLOR AT MARION ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29210",
            "telephone_number": "803-296-5804",
            "fax_number": "803-296-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOWSKI",
        "first_name": "CHARITY",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510764",
            "state": "NV"
        }
    ],
    "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 Jun 17, 2014; 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.