Individual provider Active NPI

Robert G Olds, CRNA

  • Certified Registered Nurse Anesthetist
  • Aiken, SC
National Provider Identifier
1679596233
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA80823 Issued in SC
Practice address
4211 Trolley Line Rd
Aiken, SC 29801-2749
Phone
(803) 648-2840
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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 CRNA80823 SC Primary
Registered Nurse 163W00000X 80823 SC

Addresses

Primary practice location

4211 Trolley Line Rd
Aiken, SC 29801-2749

Mailing address

4211 Trolley Line Rd
Aiken, SC 29801-2749
Phone (803) 648-2840

Other identifiers 1

IdentifierTypeStateIssuer
AN0938MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040421000367 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729074356 Reassigns benefits to 2 organizations
I20151104003254 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729074356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Services PAGroup PAC ID 7012937105, 54 clinicians

Practice addresses (Care Compare)

1606 Ashley River Rd
Charleston, SC 29407-5902
Phone (843) 763-0503

2041 Valleygate Dr
Suite 101
Fayetteville, NC 28304-3746
Phone (910) 223-1620

Merit-based Incentive Payment System (MIPS)

Final score
73.38 of 100Reported as group
Quality
77.5
Improvement activities
20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1136SCMDMarriage & Family Therapist
80823SCMDRegistered Nurse
CRNA80823SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Services, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Columbia Eye Surgery Center Inc Past Accepting new patients
Columbia Eye Surg Center Inc Past Accepting new patients

Locations

2041 Valleygate Dr
Ste 101
Fayetteville, NC 28304
Phone (910) 223-7011

2730 Georgia Rd
Franklin, NC 28734
Phone (828) 349-3636

2541 N Queen St
Kinston, NC 28501
Phone (252) 527-3636

1606 Ashley River Rd
Charleston, SC 29407
Phone (843) 556-1285

3545 Highway 17
Murrells Inlt, SC 29576
Phone (843) 294-1941

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1679596233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 TROLLEY LINE RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298012749",
            "telephone_number": "803-648-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 TROLLEY LINE RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298012749",
            "telephone_number": "803-648-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDS",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "CRNA80823",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "80823",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0938",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.