NPIMap

Dallas McKenzie Wise, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Orangeburg, SC

NPI 1962944009 · NPPES record last updated Apr 25, 2025

Key facts

NPI
1962944009
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
21068 (SC)
Practice address
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone
(803) 533-2200
NPI assigned
Nov 7, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 19

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

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 PLLC (6 clinicians)
Musc Community Physicians (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

  • Musc Medical Center Hospital · Charleston, SC · CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100 (group)
Quality
64.93
Promoting interoperability
99
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
217912SCMDRegistered Nurse
21068SCMDCertified Registered Nurse Anesthetist

Practice roles

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

Locations

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

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

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

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 217912 SC
Certified Registered Nurse Anesthetist 367500000X 21068 SC Yes

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2025.

{
    "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": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "217912",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "21068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

All providers in Orangeburg, SC · Certified Registered Nurse Anesthetist in South Carolina

Sources for this page

Verify at the official NPI Registry.