David R Davis, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Myrtle Beach, SC
NPI 1609820588 · NPPES record last updated Aug 29, 2016
Key facts
- NPI
- 1609820588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 2255 (SC)
- Practice address
- 1021 Medical Cir
#100
Myrtle Beach, SC 29572-4608 - Phone
- (843) 692-1062
- NPI assigned
- May 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060301000271 | SC | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 3173539004 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2255 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Carolina Centers of Urology and Surgery LLC | Current | Accepting new patients | |
| Atlantic Coast Anesthesia Services P.C. | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Low Country Anesthesia, PA | Current |
Accepting new patients | |
| Anesthesia Network Services, LLC | Past | Accepting new patients | |
| Grand Strand Regional Medical Center, LLC | Past | Accepting new patients | |
| Ambulatory Care Anesthesia, PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Amsol Anesthetists of Murrells Inlet, SC | Past | Accepting new patients | |
| Beach Anesthesia, LLC | Past | Accepting new patients |
Locations
955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200
822 Farrar Dr
Conway, SC 29526
Phone (843) 347-9587
2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200
1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2255 | SC | Yes |
Addresses
Primary practice location
1021 Medical Cir
#100
Myrtle Beach, SC 29572-4608
Mailing address
PO Box 4860
Murrells Inlet, SC 29576-2698
Phone (843) 651-2624
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AN0581 | Medicaid | SC |
Other providers in Myrtle Beach, SC
- Nachiket Nitin Datar
- Joseph J Davey
- Tara Davis-Boyd
- Amanda Davis
- Bill Hampton Davis
- John M Davis
- Lindley Brooke Davis
- Mercedes Zimmerman Davis
- Morgan Davis
- Rochelle L Davis
All providers in Myrtle Beach, SC · Certified Registered Nurse Anesthetist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.