PORT CITY PLASTIC SURGERY, LLC
NPI 1437385788
Surgery - Plastic and Reconstructive Surgery in North Charleston, SC
NPI Status: Active since June 01, 2009
Contact Information
2683 LAKE PARK DR
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 518-5000
NPPES record last updated: March 9, 2017. Verified against the NPPES registry weekly; last sync: July 12, 2026.
- Organization
- Surgery
- Plastic and Reconstructive Surgery
- Accepts Insurance
- CLIA Number: 42D2321902
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-10-2027
About PORT CITY PLASTIC SURGERY, LLC
This page provides the complete NPI Profile along with additional information for Port City Plastic Surgery, Llc, a provider established in North Charleston, South Carolina operating as a Surgery, focusing in plastic and reconstructive surgery . The healthcare provider is registered in the NPI registry with number 1437385788 assigned on June 2009. The practitioner's primary taxonomy code is 2086S0122X with license number 200096 (SC). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Brian G Widenhouse M.d. (Owner)
- NPI
- 1437385788
- Provider Name
- PORT CITY PLASTIC SURGERY, LLC
- Entity Type
- Organization
- Location Address
- 2683 LAKE PARK DR NORTH CHARLESTON, SC 29406
- Location Phone
- (843) 518-5000
- Mailing Address
- 43 WOODFORD ST DANIEL ISLAND, SC 29492
- Mailing Phone
- (843) 856-8398
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-01-2009
- Last Update Date
- 03-09-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Plastic and Reconstructive Surgery
- Taxonomy Code
- 2086S0122X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 200096
- License State
- SC
- Taxonomy Description
- A surgeon who specializes in plastic and reconstructive surgery.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
- Blue Direction Bronze 1 - POS
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Expanded Bronze - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- BlueEssentials Gold 1 - EPO
- BlueEssentials Gold 5 - EPO
- BlueEssentials Silver 14 - EPO
- BlueEssentials Silver 14 + Adult Vision - EPO
- BlueEssentials Silver 40 - EPO
- BlueEssentials Standard Expanded Bronze - EPO
- BlueEssentials Standard Gold - EPO
- BlueEssentials Standard Silver - EPO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Gold Value - HMO
- Molina Gold Value Plus with Adult Dental and Vision - HMO
- Molina Gold Value Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Molina Silver Saver - HMO
- Molina Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D2321902
- Facility Type
- Physician Office
- Certificate Effective Date
- April 11, 2025
- Certificate Expiration Date
- April 10, 2027
- Laboratory Director
- BRIAN G. WIDENHOUSE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Port City Plastic Surgery, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1437385788, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
NORTH CHARLESTON, SC 29406
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437385788, enumerated as an "organization" on June 01, 2009.
The provider is located at 2683 LAKE PARK DR NORTH CHARLESTON, SC 29406 and the phone number is (843) 518-5000.
Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
