BRENDA J MACK (NPI# 1700892718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700892718 |
| Entity Type | Individual |
| Full Name | BRENDA J MACK |
| Credential | CRNA |
| Practice Address |
1920 Pickens St Columbia SC 29201 |
| Mailing Address |
100 Palmetto Park Blvd Lexington SC 29072 |
| Practice Telephone | 8032547732 |
| Practice Fax Number | 8037487199 |
| Mailing Telephone | 8038060075 |
| Mailing Fax Number | 8033569846 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 22607 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | AN0105 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447371075 | Brenda Kay Mack | Marriage & Family Therapist | 7227 Broadway, Suite 302, Lemon Grove, CA 91945-1500 | 2007-04-02 |
| 1679729859 | Brenda Mack | Specialist/Technologist, Other | 4230 Harding Rd, Ste 300, Nashville, TN 37205-2013 | 2008-08-07 |
| 1063576353 | Brenda Fran Mack | Physical Therapist | 157 Union St, Marlborough, MA 01752-1228 | 2006-12-20 |
| Street Address |
1920 PICKENS ST |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639131295 | Hal Holland Crosswell IIi | Ophthalmology | 1920 Pickens St, Columbia, SC 29201 | 2006-04-06 |
| 1881089571 | Jae Youn Sarah Lee | Ophthalmology | 1920 Pickens St, Columbia, SC 29201-2632 | 2015-03-31 |
| 1629489232 | Joshua Gray Nunn | Internal Medicine | 1920 Pickens St, Columbia, SC 29201 | 2014-05-16 |
| 1063737351 | Stephen Aloysius Cross | Ophthalmology | 1920 Pickens St, Columbia, SC 29201-2632 | 2010-03-30 |
| 1720204662 | Columbia Eye Clinic, Pa | Eyewear Supplier (Equipment, not the service) | 1920 Pickens St, Columbia, SC 29201-2632 | 2007-04-18 |
| 1720175573 | Columbia Eye Surgery Center Inc | Clinic/Center | 1920 Pickens St, Columbia, SC 29201 | 2006-10-05 |
| 1467468470 | Coy L Garrick | Nurse Anesthetist, Certified Registered | 1920 Pickens St, Columbia, SC 29201 | 2006-07-31 |
| 1376559385 | Mary O Polk | Nurse Anesthetist, Certified Registered | 1920 Pickens St, Columbia, SC 29201 | 2006-07-31 |
| 1427062967 | Tyson Forrester | Nurse Anesthetist, Certified Registered | 1920 Pickens St, Columbia, SC 29201 | 2006-07-28 |
| 1912920810 | Edna J Peagler | Nurse Anesthetist, Certified Registered | 1920 Pickens St, Columbia, SC 29201 | 2006-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049421 | Souzan Moslehshirazi | Behavior Technician | 1320 Main Street Suite 300, Colombia, SC 29201 | 2020-10-02 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1548887128 | Casania's Caring Hands,llc | Home Health Aide | 1113 Belleview Street, 105, Columbia, SC 29201 | 2020-06-30 |
| 1639719909 | Benjamin Clark Watson | Acupuncturist | 1825 Sumter St., Columbia, SC 29201 | 2020-01-14 |
| 1588217574 | Aneika Daley | Specialist/Technologist | 1211 Wheat St, Columbia, SC 29201 | 2019-07-19 |
| 1447803531 | Gillian Taylor Shaughnessy | Specialist/Technologist | 147 South Marion St, Columbia, SC 29201 | 2019-07-18 |
| 1417417619 | Maria Nelson | Behavior Technician | 320 Main St Suite 300, Columbia, SC 29201 | 2019-03-22 |
| 1679041297 | Nathaniel Carl Stocker | Nurse Practitioner | 1614 Main Street, Suite C, Sc House Calls Inc, Columbia, SC 29201 | 2018-11-13 |
| 1558852855 | The Practice | Family Medicine | 1910 Gregg Street, Columbia, SC 29201 | 2018-05-22 |
| 1871095836 | Kadesjah Samuels | Behavior Technician | 1320 Main Street, Suite 300, Columbia, SC 29201 | 2018-03-06 |
| Find all providers in zip 29201 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598143521 | Lasette Denise Allen | Nurse Anesthetist, Certified Registered | 1 Hospital Dr # 3w-27, University of Missouri, Dept of Anesthesiology, Columbia, MO 65212-1000 | 2015-05-11 |
| 1366855363 | Christin Jennifer Stoner | Nurse Anesthetist, Certified Registered | 2607 Stratford Chase Pkwy, Columbia, MO 65201 | 2014-06-06 |
| 1134543614 | Meghan Lees | Nurse Anesthetist, Certified Registered | 4608 Waterloo Driv, Ste 170, Columbia, MO 65202 | 2014-02-05 |
| 1215359369 | Anna Allen | Nurse Anesthetist, Certified Registered | 1330 Taylor St, Columbia, SC 29201-2915 | 2014-01-08 |
| 1700214954 | Matthew Grayson | Nurse Anesthetist, Certified Registered | 2655 Harrison Rd, Columbia, SC 29204-2530 | 2013-10-25 |
| 1609136431 | Jill Timms Cox | Nurse Anesthetist, Certified Registered | 1436 Dahlia Rd, Columbia, SC 29205-4812 | 2012-05-27 |
| 1205109428 | Sc Anesthesiology LLC | Nurse Anesthetist, Certified Registered | 1520 Taylor Street, Suite 250, Columbia, SC 29201-2912 | 2012-02-18 |
| 1225305840 | Joseph Onukwufor Udeh | Nurse Anesthetist, Certified Registered | 7661 Woodpark Ln Apt 303, Columbia, MD 21046-2736 | 2011-11-28 |
| 1750685962 | Ramses Baguio | Nurse Anesthetist, Certified Registered | 1316 Old Highway 63 S Ste 102, Columbia, MO 65201-6092 | 2011-01-03 |
| 1518260686 | Thomas Joseph Ortbals II | Nurse Anesthetist, Certified Registered | 1600 E. Broadway, Anesthesia Department, Columbia, MO 65201-6092 | 2010-12-13 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.