SOUTHERN WV ENT
NPI 1497103386
Otolaryngology in Lewisburg, WV

NPI Status: Active since June 01, 2016

Contact Information

206 SKYLAR DR
LEWISBURG, WV
ZIP 24901
Phone: (681) 318-3540
Fax: (877) 712-1319

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Otolaryngology
Accepts Insurance
CLIA Number: 51D2132903
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 06-28-2027

About SOUTHERN WV ENT

This page provides the complete NPI Profile along with additional information for Southern Wv Ent, a provider established in Lewisburg, West Virginia operating as a Otolaryngology. The healthcare provider is registered in the NPI registry with number 1497103386 assigned on June 2016. The practitioner's primary taxonomy code is 207Y00000X with license number 23770 (WV). The provider is registered as an organization and their NPI record was last updated 10 years ago. Southern Wv Ent operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Southern Wv Ent. The authorized official of this NPI record is Justin Wayne Douglas M.d. (Owner/president)

NPI: 1497103386
Provider Legal Name: SOUTHERN WV MEDICAL AND SURGICAL SPECIALISTS PLLC
Other Organization Name: SOUTHERN WV ENT
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 206 SKYLAR DR LEWISBURG, WV 24901
Location Phone: (681) 318-3540
Location Fax: (877) 712-1319
Mailing Address: PO BOX 5482 BECKLEY, WV 25801
Mailing Phone: (304) 929-6930
Mailing Fax: (877) 712-1319
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 06-01-2016
Last Update Date: 06-22-2016
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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: Otolaryngology
Taxonomy Code: 207Y00000X
Type: Allopathic & Osteopathic Physicians
License No.: 23770
License State: WV
Taxonomy Description: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Highmark Blue Cross Blue Shield West Virginia

my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
my Blue Access WV PPO Bronze 3800 - PPO
my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision - PPO
my Blue Access WV PPO Bronze 9200 - PPO
my Blue Access WV PPO Gold 0 - PPO
my Blue Access WV PPO Gold 0 + Adult Dental and Vision - PPO
my Blue Access WV PPO Gold 1700 HSA - PPO
my Blue Access WV PPO Premier Gold 0 - PPO
my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision - PPO
my Blue Access WV PPO Premier Silver 0 - PPO
my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision - PPO
my Blue Access WV PPO Standard Bronze 7500 - PPO
my Blue Access WV PPO Standard Gold 2000 - PPO
my Blue Access WV PPO Standard Gold 2000 + Adult Dental and Vision - PPO
my Blue Access WV PPO Standard Silver 6000 - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: JUSTIN WAYNE DOUGLAS M.D.
Authorized Official Title: OWNER/PRESIDENT
Authorized Official Phone: (304) 929-6930

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: 51D2132903
Facility Type: Physician Office
Certificate Effective Date: June 29, 2025
Certificate Expiration Date: June 28, 2027
Laboratory Director: DR. JILLIAN L. DOUGLAS
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Southern Wv Ent 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.

NPI 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 1497103386, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 18 → 1 + 8

Pos 4

Unchanged

Pos 5

Doubled → 2

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 16 → 1 + 6

Check

Target digit

Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 1 → 2 3 → 6 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 2 + 0 + 6 + 3 + 1 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1497103386.