South Carolina Sleep Medicine LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

SOUTH CAROLINA SLEEP MEDICINE LLC

Practice address

92 Springview LN
Summerville, SC 29485-8153

Phone

(843) 871-4006

Fax

(843) 871-4074

NPI assigned

Jul 29, 2005

Last updated

Jul 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susannah Raye Kaelin

Title

Manager

Phone

(843) 871-4006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

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.

• Taylor Wharton Green

  • Family Nurse Practitioner
  • Summerville, SC
  • NPI 1790540904
  NPD
• David Keith Handshoe, MD

  • Pulmonary Disease Physician
  • Summerville, SC
  • NPI 1659371755
  NPD
• Kaytlin Blake Hollingsworth, PA-C

  • Physician Assistant
  • Summerville, SC
  • NPI 1790383719
  NPD
• Thomas D Kaelin Jr., DO

  • Pulmonary Disease Physician
  • N Charleston, SC
  • NPI 1740280841
  NPD
• Russell David Kitch, M.D.

  • Otolaryngology Physician
  • North Charleston, SC
  • NPI 1992705099
  NPD
• Jennifer Repaskey, PA

  • Physician Assistant
  • Summerville, SC
  • NPI 1316456478
  NPD
• John Hume Lucas IV, MD

  • Neurology Physician
  • Summerville, SC
  • NPI 1679571020
  NPD (past)
• Cynthia Lee Macdonald, NP

  • Adult Health Nurse Practitioner
  • Charleston, SC
  • NPI 1295988996
  NPD (past)
• Jeffrey Richard Fenwick, MD

  • Otolaryngology Physician
  • Springfield, MO
  • NPI 1306846407
  NPD (past)
• Darby Donovan Marshall, MD

  • Otolaryngology Physician
  • Scottsboro, AL
  • NPI 1265432371
  NPD (past)
• Thomas A Privett, MD

  • Neurology Physician
  • Lafayette, LA
  • NPI 1285632638
  NPD (past)

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1174523286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858153",
            "telephone_number": "843-871-4006",
            "fax_number": "843-871-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858153",
            "telephone_number": "843-871-4006",
            "fax_number": "843-871-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "KAELIN",
        "authorized_official_first_name": "SUSANNAH",
        "authorized_official_middle_name": "RAYE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-871-4006"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina CVS Pharmacy LLC (CVS Pharmacy #04204)
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #05580)
• South Carolina CVS Pharmacy, L.L.C. (CVS Pharmacy # 00563)
• South Carolina Diagnost Imaging Inc (Summerville MRI & Imaging)
• South Carolina Homecare, LLC (Home Health Care of South Carolina - Low Country)
• Southern Coast Spine & Pain Specialists LLC (Southern Coast Spine and Pain Specialists)
• Southern Smiles
• Alexander Dix Soutter, MD
• Space and Time Counseling LLC
• Speak Hope, LLC

• Sleep Disorder Diagnostic Clinic/Center in Summerville, SC
• Providers in Summerville, SC by specialty
• Sleep Disorder Diagnostic Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.