SOUTHERN WV ENT
NPI 1497103386
Otolaryngology in Lewisburg, WV
About Southern Wv Ent NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN WV ENT (NPI 1497103386) is a healthcare organization registered as an otolaryngology in Lewisburg, West Virginia and active in the NPI registry since June 2016. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Justin Wayne Douglas, Owner/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Wv Ent is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Southern Wv Ent, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 51D2132903
Southern Wv Medical And Surgical Specialists, PLLC · Lewisburg, WVFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southern Wv Medical And Surgical Specialists PLLC's NPI number?
The NPI number for Southern Wv Medical And Surgical Specialists PLLC is 1497103386. It was assigned to this organization in the NPPES registry on June 1, 2016. The provider is doing business as Southern Wv Ent.
Where is Southern Wv Medical And Surgical Specialists PLLC located?
Southern Wv Medical And Surgical Specialists PLLC is located at 206 Skylar Dr, Lewisburg, WV 24901. The listed phone number is (681) 318-3540.
What is Southern Wv Medical And Surgical Specialists PLLC's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Southern Wv Medical And Surgical Specialists PLLC enrolled in Medicare?
Yes. Southern Wv Medical And Surgical Specialists PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Wv Medical And Surgical Specialists PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Southern Wv Medical And Surgical Specialists PLLC, in Endocrinology, Nurse Practitioner, Otolaryngology and Registered Dietitian or Nutrition Professional. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Wv Medical And Surgical Specialists PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 51D2132903) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southern Wv Medical And Surgical Specialists PLLC accept?
Health plans from Highmark Blue Cross Blue Shield West Virginia list Southern Wv Medical And Surgical Specialists PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Wv Medical And Surgical Specialists PLLC was last updated on June 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southern Wv Ent · NPI 1497103386
Otolaryngology organization in Lewisburg, West Virginia. Organization record, active in the CMS NPPES registry since June 1, 2016.
## Identity
- **NPI:** 1497103386 (Entity type: Organization)
- **Enumerated:** June 1, 2016
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **Legal business name:** Southern Wv Medical And Surgical Specialists Pllc
- **Organization subpart:** No
- **Authorized official:** Justin Douglas, OWNER/PRESIDENT
## Practice location
- **Address:** 206 SKYLAR DR, Lewisburg, WV 24901-9383
- **Phone:** (681) 318-3540 · **Fax:** (877) 712-1319
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Endocrinology (1), Nurse Practitioner (1), Otolaryngology (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 22, 2016
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1497103386) · Data from the CMS NPPES public registry.