NPIMap

Organization Active NPI

Colleton Medical Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Walterboro, SC
National Provider Identifier
1659316958
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
COLLETON MEDICAL ANESTHESIA, LLC
Practice address
501 Robertson Blvd
Walterboro, SC 29488-2787
Phone
(843) 782-2000
Fax
(843) 549-6254
NPI assigned
Jun 19, 2006
Last updated
Jul 13, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
WALTERBORO COMMUNITY HOSPITAL, INC D/B/A COLLETON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Mr. H H Thompson
Title
Chief Financial Officer
Phone
(843) 782-2602

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

501 Robertson Blvd
Walterboro, SC 29488-2787

Mailing address

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 782-2000

Other identifiers 1

IdentifierTypeStateIssuer
GP3871MedicaidSC

National Provider Directory

National Provider Directory
Part of
Columbia Colleton Med C

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1659316958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-782-2000",
            "fax_number": "843-549-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "843-782-2000",
            "fax_number": "843-549-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLETON MEDICAL ANESTHESIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALTERBORO COMMUNITY HOSPITAL, INC D/B/A COLLETON MEDICAL CENTER",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "843-782-2602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3871",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.