Individual provider Active NPI

Kimberly Claire Ryan, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1780836205
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
18266 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-1436
NPI assigned
Oct 15, 2008
Last updated
May 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2024

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 18266 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

PO Box 603484
Charlotte, NC 28260-3484
Phone (803) 765-1838

Other identifiers 2

IdentifierTypeStateIssuer
NAN902MedicaidSC
8053658MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090601000580 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799834362 Reassigns benefits to 3 organizations
I20130826000400 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799834362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as group
Quality
83.18
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18266SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University Hospital Authority CurrentSince Jun 10, 2021 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Nov 12, 2017 Accepting new patients
American Anesthesiology of North Carolina, PLLC Current Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 12, 2014 Accepting new patients
Coastal Healthcare Resources Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 9, 2013 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2025 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Medical University Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Jun 10, 2021 Accepting new patients
York County Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2013 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Oct 1, 2020 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 12, 2014 Accepting new patients
Charlotte Medical Center Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients

Locations

1000 Blythe Blvd
Fl 5
Charlotte, NC 28203
Phone (704) 355-8983

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

101 W 27th St
Lumberton, NC 28358
Phone (910) 739-0770

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

1 Poston Rd
Ste 110
Charleston, SC 29407
Phone (843) 876-1347

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

164 Glenwood Dr
Rock Hill, SC 29732
Phone (803) 325-9010

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

Hospital & facility affiliations 7

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1780836205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603484",
            "telephone_number": "803-765-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KIMBERLY",
        "middle_name": "CLAIRE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "18266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN902",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053658",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2024; 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.