Individual provider Active NPI

Kelly David Miner, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1659351443
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
18153 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
Fax
(864) 522-3705
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP 9289116 FL
Certified Registered Nurse Anesthetist 367500000X 18153 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

701 Grove Rd
Greenville, SC 29605-5611
Phone (864) 455-7000

Other identifiers 1

IdentifierTypeStateIssuer
AN2255MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130530000460 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961548383 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Anesthesia AssociatesGroup PAC ID 3274446422, 111 clinicians

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (864) 255-1000

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 269-3419

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Greenville Health System CurrentSince Apr 8, 2013 Accepting new patients
St. Francis Hospital, Inc. CurrentSince Oct 22, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients
Palmetto Anesthesia Associates CurrentSince Mar 4, 2024 Accepting new patients
Greenville Health System Current Accepting new patients
St Francis Hospital Inc CurrentSince Oct 22, 2023 Accepting new patients
Prisma Health-Upstate CurrentSince Oct 1, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients
Prisma Health-Upstate Current Accepting new patients
Pathology Associates of Greenville PA Current Accepting new patients
Clearwater Pain Management Associates Past Accepting new patients
West Florida Anesthesia Consultants, PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of Pinellas County Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

1413 John B White SR Blvd
Ste D
Spartanburg, SC 29306
Phone (864) 587-5768

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 14

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.

View all 14

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1659351443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055611",
            "country_code": "US",
            "telephone_number": "864-455-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINER",
        "first_name": "KELLY",
        "middle_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9289116",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "18153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2255",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.