MEDICARE: JAMES A CARLEN IV CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	1653	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427015205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A CARLEN IV CRNA

Provider Business Mailing Address
First Line	:	2637 PINE LAKE DR
Second Line	:	FIRST FLOOR
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-3742
Country	:	US
Telephone Number	:	803-296-2548
Fax Number	:	803-296-2548

Provider Business Practice Location Address
First Line	:	2720 SUNSET BLVD
Second Line	:	LEXINGTON MEDICAL CENTER
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-3742
Country	:	US
Telephone Number	:	803-791-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	10/28/2025

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