SUMMERVILLE SURGICAL ASSOCIATES, PA
NPI 1902967912
Specialist in Summerville, SC

NPI Status: Active since December 13, 2006

Contact Information

87 SPRINGVIEW LN
SUITE A
SUMMERVILLE, SC
ZIP 29485
Phone: (843) 851-0200
Fax: (843) 851-9398

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  • Organization
  • Specialist
  • Accepts Insurance
  • CLIA Number: 42D2074662
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 03-12-2026

About SUMMERVILLE SURGICAL ASSOCIATES, PA

This page provides the complete NPI Profile along with additional information for Summerville Surgical Associates, Pa, a provider established in Summerville, South Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1902967912 assigned on December 2006. The practitioner's primary taxonomy code is 174400000X with license number 15402 (SC). The provider is registered as an organization and their NPI record was last updated 6 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 Gerald C. Warren Md (Owner Of Business)

NPI
1902967912
Provider Name
SUMMERVILLE SURGICAL ASSOCIATES, PA
Entity Type
Organization
Location Address
87 SPRINGVIEW LN SUITE A SUMMERVILLE, SC 29485
Location Phone
(843) 851-0200
Location Fax
(843) 851-9398
Mailing Address
87 SPRINGVIEW LN SUITE A SUMMERVILLE, SC 29485
Mailing Phone
(843) 851-0200
Mailing Fax
(843) 851-9398
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-13-2006
Last Update Date
08-22-2020
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
15402
License State
SC
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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
  • 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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*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

GERALD C. WARREN MD

Authorized Official Title
OWNER OF BUSINESS
Authorized Official Phone
(843) 851-0200

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
GP0766MEDICAID (05)SC 

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
42D2074662
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
March 13, 2024
Certificate Expiration Date
March 12, 2026
Laboratory Director
MARC D. NOBLE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Summerville Surgical Associates, Pa 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 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 1902967912, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

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
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
0
Doubled → 0
Pos 4
2
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
Check
2
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 0 → 0 9 → 18 → 9 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 0 + 2 + 1 + 8 + 6 + 1 + 4 + 9 + 2 + 24 = 68

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

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1902967912.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Physician Assistant
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Family Medicine
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Family Medicine
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Family Medicine (Adult Medicine)
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Nurse Practitioner (Primary Care)
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485
Family Medicine
87 SPRINGVIEW LN
SUMMERVILLE, SC 29485

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902967912, enumerated as an "organization" on December 13, 2006.

The provider is located at 87 SPRINGVIEW LN SUITE A SUMMERVILLE, SC 29485 and the phone number is (843) 851-0200.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.