Summerville Surgical Associates, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

15402 Issued in SC

Legal business name

SUMMERVILLE SURGICAL ASSOCIATES, PA

Practice address

87 Springview LN
Suite a
Summerville, SC 29485-8154

Phone

(843) 851-0200

Fax

(843) 851-9398

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Gerald C. Warren, MDNPI 1063417228

Title

Owner of Business

Phone

(843) 851-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Gerald C Warren, MD

  • Specialist
  • Summerville, SC
  • NPI 1063417228
  NPD Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902967912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 SPRINGVIEW LN",
            "address_2": "SUITE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858154",
            "telephone_number": "843-851-0200",
            "fax_number": "843-851-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SPRINGVIEW LN",
            "address_2": "SUITE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858154",
            "telephone_number": "843-851-0200",
            "fax_number": "843-851-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE SURGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER OF BUSINESS",
        "authorized_official_telephone_number": "843-851-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "15402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0766",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summerville Physical Therapy & Balance Rehabilitation for Adults, LLC
• Summerville Primary Care
• Summerville Primary Eyecare LLC (Summerville Primary Eyecare)
• Summerville Sleep Consultants LLC
• Summerville Smiles Dental Office, PC
• Summit Hand Therapy, LLC
• Monica V Sumpter
• Ramona Perez Surprenant
• Susan S. Crocker, M.D., LLC
• Abbegayle Ann Sutterfield, OTR L

• Specialist in Summerville, SC
• Providers in Summerville, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.