Individual provider Active NPI

Anne M Sudduth, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1801921168
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
019491 Issued in SC
Practice address
1 Saint Francis Dr
Greenville, SC 29601-3955
Phone
(864) 675-4510
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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 019491 SC Primary

Addresses

Primary practice location

1 Saint Francis Dr
Greenville, SC 29601-3955

Mailing address

130 Whittington Dr
Greenville, SC 29615-2675
Phone (864) 297-3774

Other identifiers 2

IdentifierTypeStateIssuer
19491OtherSCAANA LICENSE
15463OtherSCSTATE NURSING LICENSE

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

State licenses

LicenseStateTypeSpecialty
019491SCMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1801921168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WHITTINGTON DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152675",
            "telephone_number": "864-297-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT FRANCIS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013955",
            "telephone_number": "864-675-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "ANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "019491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA LICENSE",
            "identifier": "19491",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NURSING LICENSE",
            "identifier": "15463",
            "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 11, 2010; 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.