Individual provider Active NPI

Thomas G Tyner, CRNA

  • Certified Registered Nurse Anesthetist
  • Orangeburg, SC
National Provider Identifier
1720091390
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3012 Issued in SC
Practice address
3000 St Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 395-2200
NPI assigned
Aug 14, 2006
Last updated
Apr 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3012 SC Primary

Addresses

Primary practice location

3000 St Matthews Rd
Orangeburg, SC 29118-1442

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4499

Other identifiers 8

IdentifierTypeStateIssuer
000000194021OtherSCUNISON
5S867OtherLAMEDICAE PART B
576008010015OtherSCTRICARE
AN1516MedicaidSC
576008010006OtherSCBLUE CHOICE
MM5083OtherMEMEDICARE PART B
20056087OtherSCFIRST CHOICE
576008010009OtherSCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3012NCMDMassage Therapist
3012SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Centers of Urology and Surgery LLC CurrentSince Dec 18, 2023 Accepting new patients
Palmetto Gastroenterology & Hepatology, PA CurrentSince Feb 26, 2023 Accepting new patients
The Blue Hill Memorial Hospital Past Accepting new patients
Penobscot Valley Hospital Past Accepting new patients
Pain Management, LLC Past Accepting new patients
North American Partners in Anesthesia New Hampshire LLP Past Accepting new patients
Seacoast Anesthesia PA Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Cape Cod Anesthesia Associates, Inc. Past Accepting new patients
Spectrum Healthcare Partners, PA Past Accepting new patients
Norumbega Medical Specialists, LTD Past Accepting new patients
Carolina Anesthesiology Associates PA Past Accepting new patients
Carolina Anesthesiology Associates PA Past Accepting new patients

Locations

103 Gregg Ave NW
Aiken, SC 29801
Phone (803) 226-0799

103 Gregg Ave NW
Ste 100
Aiken, SC 29801
Phone (803) 226-0799

822 Farrar Dr
Conway, SC 29526
Phone (843) 347-9587

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/penob-eadbba22

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1720091390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4499",
            "fax_number": "803-395-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ST MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-395-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNER",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "3012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000194021",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAE PART B",
            "identifier": "5S867",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "576008010015",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1516",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "576008010006",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "MM5083",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "20056087",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "576008010009",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.