Organization Active NPI

Provident Health Services, Inc.

Doing business as ACI Surgical Associates

  • Surgery Physician
  • Bluffton, SC
National Provider Identifier
1366519530
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PROVIDENT HEALTH SERVICES, INC.
Doing business as
ACI Surgical Associates
Practice address
7 Mallet Way
Bluffton, SC 29910-6064
Phone
(912) 350-7412
Fax
(912) 350-7297
NPI assigned
Nov 30, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Robin J. Maddox
Title
Provider Enrollment Coordinator
Phone
(912) 350-9335

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Surgical Oncology Physician 2086X0206X NU

Addresses

Primary practice location

7 Mallet Way
Bluffton, SC 29910-6064

Mailing address

PO Box 933213
Atlanta, GA 31193-1968
Phone (912) 350-7412

Other names 1

  • ACI Surgical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

4700 Waters Ave
Fl 2
Savannah, GA 31404
Phone (912) 350-6277

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366519530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933213",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931968",
            "telephone_number": "912-350-7412",
            "fax_number": "912-350-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MALLET WAY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106064",
            "telephone_number": "912-350-7412",
            "fax_number": "912-350-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "912-350-9335"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACI Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.