| Amanda L Wardlaw, | |
|
2720 Sunset Blvd, West Columbia, SC 29169-4810 | |
| (803) 935-8292 | |
| Not Available |
| Full Name | Amanda L Wardlaw |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 20 Years |
| Location | 2720 Sunset Blvd, West Columbia, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487610135 | NPI | - | NPPES |
| AN1412 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2638 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Prisma Health Baptist Parkridge | Columbia, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medstream Anesthesia Pllc | 7416198049 | 515 |
| Prisma Health University Medical Group | 8325950983 | 2220 |
| Entity Name | Prisma Health University Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295763217 PECOS PAC ID: 8325950983 Enrollment ID: O20031103000238 |
| Entity Name | Prisma Health-midlands |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205889458 PECOS PAC ID: 6800708330 Enrollment ID: O20031110000506 |
| Entity Name | Beach Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215061429 PECOS PAC ID: 6103924014 Enrollment ID: O20070530000620 |
| Entity Name | Medstream Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20140304001021 |
| Entity Name | Lexington Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710634753 PECOS PAC ID: 2567872070 Enrollment ID: O20201208000922 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda L Wardlaw, 300 E Mcbee Ave, Greenville, SC 29601-2842 Ph: (864) 522-8603 | Amanda L Wardlaw, 2720 Sunset Blvd, West Columbia, SC 29169-4810 Ph: (803) 935-8292 |
Aimee Yates Gondi, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2720 Sunset Blvd., West Columbia, SC 29169 Phone: 803-791-2000 | |
Mrs. Aimee Ahn Durgin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-791-2000 | |
Jeffrey M Scoggin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-935-8538 Fax: 803-791-2660 | |
Noreen Lyday Dudley, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-791-2000 | |
Jessica Leigh Rosebrock, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-791-2000 | |
Hannah Elizabeth Garrison, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-935-8538 | |
Cori Jane Stroebel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-935-8538 Fax: 803-791-2660 |