Individual provider Active NPI

Dallas McKenzie Wise, CRNA

  • Certified Registered Nurse Anesthetist
  • Orangeburg, SC
National Provider Identifier
1962944009
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21068 Issued in SC
Practice address
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 533-2200
NPI assigned
Nov 7, 2016
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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 21068 SC Primary
Registered Nurse 163W00000X 217912 SC

Addresses

Primary practice location

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Mailing address

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Other practice location 1

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170810003811 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799056685 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Carolina School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Care Anesthesia of North Carolina PLLCGroup PAC ID 9133560394, 6 clinicians
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

121 Park Central Dr
Suite 100
Columbia, SC 29203-6476
Phone (803) 252-3373

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217912SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince May 5, 2025 Accepting new patients
Access Care Anesthesia of North Carolina PLLC CurrentSince May 19, 2025 Accepting new patients
SC Anesthesiology LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Beach Anesthesia, LLC CurrentSince Oct 26, 2021 Accepting new patients
Musc Community Physicians CurrentSince Feb 1, 2024 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Palmetto Moon Anesthesia, LLC CurrentSince Oct 12, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince May 5, 2025 Accepting new patients
Musc Community Physicians Current Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Jun 17, 2017 Accepting new patients
Musc Community Physicians CurrentSince Feb 1, 2024 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

121 Park Central Dr
Ste 100
Columbia, SC 29203
Phone 61064489001

1520 Taylor St
Columbia, SC 29201
Phone (803) 254-8449

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

3045 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 665-2049

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1962944009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-533-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "DALLAS",
        "middle_name": "MCKENZIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "21068",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "217912",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 25, 2025; 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.