PROVIDENT HEALTH SURGICAL ASSOCIATES, INC. (NPI# 1083862882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083862882 |
| Entity Type | Organization |
| Organization Name | PROVIDENT HEALTH SURGICAL ASSOCIATES, INC. |
| Other Organization Name | ACI SURGICAL ASSOCIATES |
| Practice Address |
14 Okatie Center Blvd. South Suite 101 Okatie SC 29909 |
| Mailing Address |
Po Box 102019 Atlanta GA 30368-2019 |
| Practice Telephone | 9123502299 |
| Practice Fax Number | 9123502298 |
| Mailing Telephone | 9123502299 |
| Mailing Fax Number | 9123502298 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2011-05-03 |
| Authorized Official Name | MRS. ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 9123509335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP5024 | 05 | |
| SC | RR MEDICARE | DO4198 | 01 |
| Other Name | Type Code |
|---|---|
| ACI Surgical Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104113307 | Provident Health Surgical Associates, Inc. | Nurse Practitioner | 4700 Waters Ave, Suite 405, Savannah, GA 31404-6220 | 2011-07-08 |
| 1912149907 | Provident Health Surgical Associates, Inc. | Surgery | 4750 Waters Ave, Suite 103, Savannah, GA 31404-6200 | 2009-04-06 |
| 1316195373 | Provident Health Surgical Associates, Inc. | Obstetrics & Gynecology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2008-09-03 |
| Street Address |
14 OKATIE CENTER BLVD. SOUTH SUITE 101 |
| City | OKATIE |
| State | SC |
| Zip Code | 29909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649292079 | John N. Burling | Emergency Medicine | 14 Okatie Center Blvd. South, Suite 101, Okatie, SC 29909 | 2006-07-24 |
| 1609170901 | Mppg, Inc. | Pediatrics | 14 Okatie Center Blvd. South, Suite 101, Okatie, SC 29909 | 2010-12-29 |
| 1982925145 | Mppg, Inc. | Obstetrics & Gynecology | 14 Okatie Center Blvd. South, Suite 101, Okatie, SC 29909 | 2010-06-22 |
| 1619037009 | Mppg, Inc. | Family Medicine | 14 Okatie Center Blvd. South, Suite 101, Okatie, SC 29909 | 2006-12-08 |
| 1275600439 | Mppg, Inc. | Surgery | 14 Okatie Center Blvd. South, Suite 101, Okatie, SC 29909 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915027 | Vdp Okatie LLC | Dentist | 10 William Pope Drive, Suite #2, Okatie, SC 29909 | 2020-09-04 |
| 1598379729 | Wellness Institute | Nurse Practitioner | 100 Okatie Center Boulevard North, Okatie, SC 29909 | 2020-09-04 |
| 1649764119 | Sprenger Healthcare of Bluffton, Inc | Skilled Nursing Facility | 60 Okatie Village Drive, Okatie, SC 29909 | 2018-06-19 |
| 1396144291 | Joel Bond | Physical Therapist | 100 Okatie Center Blvd. North, Bluffton, SC 29909 | 2014-08-15 |
| 1528484615 | Barnwell Counseling, LLC | Counselor | 1321 Calhoun Promenade Street, Bluffton, SC 29909 | 2014-03-13 |
| 1508299561 | Katherine Elizabeth Abell | Dentist | 40 Okatie Center Blvd S Ste 302, Okatie, SC 29909 | 2013-08-14 |
| 1578816716 | Costrini Sleep Services, Inc. | Internal Medicine | 8 Okatie Center Blvd., South, Suite 101, Bluffton, SC 29909 | 2012-10-25 |
| 1477845659 | Heart Associate of Hilton Head PC | Internal Medicine | 40 Okatie Boulevard, Suite 100-1, Okatie, SC 29909 | 2011-05-06 |
| 1366740326 | Edward Leonard Meyerink IIi | Pharmacist | 138 Okatie Center Blvd South, (walgreens), Okatie, SC 29909 | 2011-03-01 |
| 1407162944 | Stacey Mae Michaels | Behavioral Analyst | 418 Pinckney Colony Rd, Okate, SC 29909 | 2010-08-22 |
| Find all providers in zip 29909 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497113617 | Roper Saint Francis Physicians Network | Surgery | 1112 N Main St Ste C, Summerville, SC 29483 | 2016-02-02 |
| 1063858736 | Roper Saint Francis Physicians Network | Surgery | 2145 Henry Tecklenburg Drive, Suite 100, Charleston, SC 29414 | 2013-05-21 |
| 1760827703 | Spartanburg Medical Center | Surgery | 2759 South Highway 14, Suite B, Greer, SC 29650-4926 | 2013-05-03 |
| 1811251366 | Bernardo Franssen Canovas | Surgery | 125 Doughty St Ste 660, Charleston, SC 29403-5731 | 2012-06-29 |
| 1447536750 | Lexington County Health Services District, Inc. | Surgery | 146 East Hospital Dr, Ste 200, West Columbia, SC 29169-4800 | 2011-11-01 |
| 1174610208 | Alexander Ashish Parikh | Surgery | 890 W Faris Rd Ste 320, Greenville, SC 29605-4281 | 2006-10-09 |
| 1518565621 | Lexington Health Inc | Surgery | 146 E Hospital Dr Ste 400, West Columbia, SC 29169-4800 | 2020-10-12 |
| 1013514330 | Lexington Health Inc | Surgery | 146 E Hospital Dr Ste 200, West Columbia, SC 29169-4800 | 2020-10-09 |
| 1215572714 | Lexington County Health Services District, Inc. | Surgery | 146 E Hospital Dr Ste 400, West Columbia, SC 29169-4800 | 2019-11-08 |
| 1922571223 | Roper Saint Francis Physicians Network | Surgery | 2145 Henry Tecklenburg Dr Ste 100, Charleston, SC 29414-5894 | 2019-01-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROVIDENT HEALTH SURGICAL ASSOCIATES, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.