Individual provider Active NPI

Brittany Mimms, CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, SC
National Provider Identifier
1609457431
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
25015 Issued in SC
Practice address
506 E Cheves St Ste 202
Florence, SC 29506-2616
Phone
(843) 777-7000
Fax
(843) 777-7005
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 230794 SC
Certified Registered Nurse Anesthetist 367500000X 25015 SC Primary

Addresses

Primary practice location

506 E Cheves St Ste 202
Florence, SC 29506-2616

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210916003323 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638576713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Medical University of South Carolina College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kershaw Anesthesia LLCGroup PAC ID 2567764384, 18 clinicians
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

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

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-7000

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • Carolina Pines Regional Medical Center Hospital, Hartsville, SC, CCN 420010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230794SCMDRegistered Nurse
25015SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Multi-Specialty Current Accepting new patients
McLeod Physician Associates II CurrentSince Aug 1, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jun 9, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Multi-Specialty CurrentSince Jun 9, 2021 Accepting new patients
Kershaw Anesthesia, LLC Multi-Specialty CurrentSince Jul 1, 2025 Accepting new patients
McLeod Physician Associates II Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients

Locations

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

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 6

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 2

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1609457431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-777-7000",
            "fax_number": "843-777-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E CHEVES ST STE 202",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062616",
            "telephone_number": "843-777-7000",
            "fax_number": "843-777-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMMS",
        "first_name": "BRITTANY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-06-02",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "230794",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "25015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.