NPIMap

Organization Active NPI

Summerville Sleep Consultants LLC

  • Specialist
  • Summerville, SC
National Provider Identifier
1265507404
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SUMMERVILLE SLEEP CONSULTANTS LLC
Practice address
92 Springview LN
Summerville, SC 29485-8153
Phone
(843) 871-4006
Fax
(843) 871-4074
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Ms. Susannah Raye Kaelin
Title
Manager
Phone
(843) 871-4006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825000236 SC Part B Supplier - Clinic/Group Practice 5799759791 Receives reassigned benefits from 11 practitioners
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Locations

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

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1265507404",
    "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": "SUMMERVILLE SLEEP CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-02-03",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.