Individual provider Active NPI

Mary Evanne Vang, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, SC
National Provider Identifier
1992226856
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21102 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 21102 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

5 medical park road
columbia, SC 29203
Phone (803) 296-5010

Other identifiers 1

IdentifierTypeStateIssuer
AN2771MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180102000355 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173881851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Carolina School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

7 Independence PT
Suite 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Hospital & facility affiliations

  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21102SCMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2022 Accepting new patients
Prisma Health-Midlands CurrentSince Jan 1, 2018 Accepting new patients
Prisma Health-Midlands CurrentSince Jan 1, 2018 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health-Midlands Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

400 Palmetto Health Pkwy
Ste 2137
Columbia, SC 29212

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

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

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

Organizations & group practices 6

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 2

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1992226856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 medical park road",
            "address_purpose": "LOCATION",
            "city": "columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-296-5010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANG",
        "first_name": "MARY",
        "middle_name": "EVANNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "21102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2771",
            "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 Jan 26, 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.