Southeastern Ear Nose Throat Allergy and Sleep Disorders Institute

Primary specialty

Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X

License

28760 Issued in SC

Legal business name

SOUTHEASTERN EAR NOSE THROAT ALLERGY AND SLEEP DISORDERS INSTITUTE

Practice address

1040 Pinnacle Point Dr
Columbia, SC 29223-5735

Phone

(803) 509-7200

Fax

(803) 509-7213

NPI assigned

Apr 20, 2010

Last updated

Mar 7, 2023By 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

Dr. Chad B Gunnlaugsson, MDNPI 1194755314

Title

Owner

Phone

(803) 509-7200

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 5

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.

• Chad B Gunnlaugsson, M.D.

  • Otolaryngology Physician
  • Columbia, SC
  • NPI 1194755314
  Medicare reassignment Care Compare group NPD Authorized official
• Beth Ann Waywood, AUD

  • Audiologist
  • Col, SC
  • NPI 1316057698
  Medicare reassignment Care Compare group NPD
• Jennifer Leigh Matthews, APRN

  • Family Nurse Practitioner
  • Irmo, SC
  • NPI 1326513557
  Medicare reassignment NPD
• Katherine Crow, NURSE PRACTITIONER

  • Nurse Practitioner
  • Columbia, SC
  • NPI 1518688621
  NPD
• Peter Wood Whitson, M.S.

  • Audiologist
  • Columbia, SC
  • NPI 1194870865
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1770809428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PINNACLE POINT DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235735",
            "telephone_number": "803-509-7200",
            "fax_number": "803-509-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PINNACLE POINT DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235735",
            "telephone_number": "803-509-7200",
            "fax_number": "803-509-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN EAR NOSE THROAT ALLERGY AND SLEEP DISORDERS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2023-03-07",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "GUNNLAUGSSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-509-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "SC",
            "license": "28760",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "SC",
            "license": "28760",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "SC",
            "license": "28760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5437",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Center for Family Development & Institute for Family Enrichm
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• Southeast Neuropathy & Treatment Center, LLC
• Southeast Therapy LLC
• Southeastern Chiropractic Center P C
• Southeastern Health Care Group LLC
• Southeastern Medical Brokers, Inc.
• Southeastern Medical Supply Co (Southeastern Diabetic Supply)
• Southeastern Medical Supply Inc
• Joel Allyn Southerlin II, LISW-CP

• Otolaryngology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Otolaryngology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.