NPIMap

Organization Active NPI

South Carolina Sleep Medicine LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Summerville, SC
National Provider Identifier
1174523286
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

92 Springview LN
Summerville, SC 29485-8153

Mailing address

92 Springview LN
Summerville, SC 29485-8153
Phone (843) 871-4006

Other identifiers 1

IdentifierTypeStateIssuer
GP3738MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914000274 SC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5294702817 Practice locations: Summerville, SC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2320342South Carolina Sleep Medicine, LLC92 Springview Lane, Summerville, SC 29485Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3738",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • 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.