Individual provider Active NPI

Phillip Merrida Hampton, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbia, SC
National Provider Identifier
1972521243
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2916 Issued in SC
Practice address
3301 Harden St Ext 5 Medical Park
Palmetto Health Richland
Columbia, SC 29203
Phone
(803) 296-2548
Fax
(803) 296-2525
NPI assigned
Jul 17, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 2916 SC Primary

Addresses

Primary practice location

3301 Harden St Ext 5 Medical Park
Palmetto Health Richland
Columbia, SC 29203

Mailing address

1321 Lady Street 1St Floor
Palmetto Health
Columbia, SC 29201
Phone (803) 296-2548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120326000763 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840295770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prodigy Office Anesthesia, LLCGroup PAC ID 8921450776, 9 clinicians

Practice addresses (Care Compare)

1710 Cumberland Falls Hwy
Corbin, KY 40701-2727
Phone (606) 528-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2916SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prodigy Office Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 5, 2023 Accepting new patients

Locations

1710 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 528-6700

Organizations & group practices 1

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 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972521243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 LADY STREET 1ST FLOOR",
            "address_2": "PALMETTO HEALTH",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-296-2548",
            "fax_number": "803-296-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 HARDEN ST EXT 5 MEDICAL PARK",
            "address_2": "PALMETTO HEALTH RICHLAND",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-296-2548",
            "fax_number": "803-296-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "PHILLIP",
        "middle_name": "MERRIDA",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "2916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.