Charleston ENT Associates, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Charleston, SC
NPI 1124026422 · NPPES record last updated Mar 10, 2016
Key facts
- NPI
- 1124026422
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- ASF072 (SC)
- Legal business name
- CHARLESTON ENT ASSOCIATES, LLC
- Practice address
- 1849 Savage Rd
Charleston, SC 29407-4726 - Phone
- (803) 766-7103
- NPI assigned
- Jul 11, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- CHARLESTON ENT ASSOCIATES, LLC
Authorized official
- Name
- Ms. Charlene Thompson
- Title
- Billing Manager
- Phone
- (843) 763-5342
Other NPIs with the same Medicare PAC ID 1
Practitioners 103
-
Alston Adams, MD
-
Sarah Bartlett, AU.D.
-
Andrew P Battiata, MD, MS
-
Edward G Behrens, M.D.
-
Madonna Morgan Blair, AU.D.
-
Anna L Bouknight, MD
-
Tracy E Brande, M.S.
-
Eugene G Brown, M.D.
-
Jennifer Campbell, APRN-CNP
-
Shelby Allison Carney, APRN
-
Lisa Anne Crouch, MA
-
Linda A. Dicamillo, AUD, CCC-A
-
Thomas Slade Dozier, M.D.
-
Nicholas B Drury, MD
-
Melissa Ann Franklin, M.A., CCC-A
-
Eric D Jewell, NP-C
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Charleston ENT Associates LLC Dba Surgery Center of Charleston
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130313000555 | SC | Part B Supplier - Ambulatory Surgical Center | 4082662234 | Practice locations: Charleston, SC |
National Provider Directory
- Part of
- Surgery Center of Charl
Locations
497 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 763-0543
298 Midland Pkwy
Summerville, SC 29485
Phone (843) 873-8733
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | ASF072 | SC | Yes |
Addresses
Primary practice location
1849 Savage Rd
Charleston, SC 29407-4726
Mailing address
2295 Henry Tecklenburg Dr.
Charleston, SC 29414-7801
Phone (803) 766-7103
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ASC044 | Medicaid | SC | |
| P01419594 | Other | SC | RAILROAD MEDICARE |
Other names
- Surgery Center of Charleston
Other providers in Charleston, SC
- Charleston Dental Associates, LLC
- Charleston Emergency Services LLC
- Charleston Endoscopy Center
- Charleston ENT Associates
- Charleston ENT Associates LLC
- Charleston ENT Associates, LLC
- Charleston Eye Care PA Inc
- Charleston Facial Plastic Surgery LLC
- Charleston Family Center, LLC
- Charleston Family Dentistry of West Ashley
All providers in Charleston, SC · Ambulatory Surgical Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.