NPIMap

Organization Active NPI

Charleston ENT Associates, LLC

Doing business as Surgery Center of Charleston

  • Ambulatory Surgical Clinic/Center
  • Charleston, SC
National Provider Identifier
1124026422
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
ASF072 Issued in SC
Legal business name
CHARLESTON ENT ASSOCIATES, LLC
Doing business as
Surgery Center of Charleston
Practice address
1849 Savage Rd
Charleston, SC 29407-4726
Phone
(803) 766-7103
NPI assigned
Jul 11, 2005
Last updated
Mar 10, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CHARLESTON ENT ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Charlene Thompson
Title
Billing Manager
Phone
(843) 763-5342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X ASF072 SC Primary

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 names 1

  • Surgery Center of Charleston Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000555 SC Part B Supplier - Ambulatory Surgical Center 4082662234 Practice locations: Charleston, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124026422. Details of each certification follow.

Hospital certification: CCN 420111

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SURGERY CENTER OF CHARLESTON
Certification status
Terminated Voluntary: merger or closure, Jul 1, 2021
Provider type (POS)
Hospital – Short-term
Participating since
Mar 31, 2020
Last certification
Mar 31, 2020
Beds
1
Ownership / control type
Private (for profit)
Facility address
1849 Savage Rd
Charleston, SC 29407

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Charleston ENT Associates LLC Dba Surgery Center of CharlestonCCN 42C0001046
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Charleston ENT Associates L

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

410 University Pkwy
Ste 1400
Aiken, SC 29801
Phone (803) 644-4264

1231 Ribaut Rd
Beaufort, SC 29902
Phone (843) 525-6622

497 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 763-0543

5000 Epson Plantation Dr
Moncks Corner, SC 29461
Phone (843) 761-2000

3510 N Highway 17
Ste 135
Mt Pleasant, SC 29466
Phone (843) 654-7494

298 Midland Pkwy
Summerville, SC 29485
Phone (843) 873-8733

Practitioners & affiliated clinicians

Practitioners 89

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 89

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1124026422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR.",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "803-766-7103",
            "fax_number": "843-576-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAVAGE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "803-766-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON ENT ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLESTON ENT ASSOCIATES, LLC",
        "enumeration_date": "2005-07-11",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "843-763-5342",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "SC",
            "license": "ASF072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center of Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.