Individual provider Active NPI

Kelly A Carmack, CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1821065269
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN1504 Issued in SC
Practice address
9326 Medical Plaza Dr
Ste B
Charleston, SC 29406-9138
Phone
(843) 553-7070
Fax
(843) 553-2223
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 APN1504 SC Primary

Addresses

Primary practice location

9326 Medical Plaza Dr
Ste B
Charleston, SC 29406-9138

Mailing address

9326 Medical Plaza Dr
Ste B
Charleston, SC 29406-9138
Phone (843) 553-7070

Other identifiers 1

IdentifierTypeStateIssuer
AN1071MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081230000050 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648332627 Reassigns benefits to 4 organizations
I20250304000148 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648332627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN1504SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC CurrentSince Jun 1, 2018 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Feb 1, 2025 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 5, 2023 Accepting new patients
Anesthesia Associates CurrentSince Jan 1, 2018 Accepting new patients
South Baldwin Anesthesia, PC CurrentSince Jul 1, 2019 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 5, 2023 Accepting new patients
Palmetto Anesthesia Specialists LLC Past Accepting new patients
Trident Anesthesia Group, LLC Past Accepting new patients
St Vincents East Past Accepting new patients
Mobile Anesthesia, LLC Past Accepting new patients

Locations

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

1007 Goodyear Ave
Gadsden, AL 35903
Phone (256) 494-4000

1 Commerce Sq
Gadsden, AL 35901

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

1755 Highway 34 E
Ste 1100
Newnan, GA 30265
Phone (770) 252-7510

Organizations & group practices 11

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821065269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9326 MEDICAL PLAZA DR",
            "address_2": "STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069138",
            "telephone_number": "843-553-7070",
            "fax_number": "843-553-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9326 MEDICAL PLAZA DR",
            "address_2": "STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069138",
            "telephone_number": "843-553-7070",
            "fax_number": "843-553-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "APN1504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN1071",
            "state": "SC"
        }
    ],
    "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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.