SOUTHEASTERN EAR NOSE THROAT ALLERGY AND SLEEP DISORDERS INSTITUTE (NPI# 1770809428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770809428 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN EAR NOSE THROAT ALLERGY AND SLEEP DISORDERS INSTITUTE |
| Practice Address |
1040 Pinnacle Point Dr Columbia SC 29223-5735 |
| Practice Telephone | 8035097200 |
| Practice Fax Number | 8035097213 |
| Mailing Telephone | 8035097200 |
| Mailing Fax Number | 8035097213 |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-05-04 |
| Authorized Official Name | DR. CHAD B GUNNLAUGSSON (OWNER) |
| Authorized Official Telephone | 8035097200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0012X |
Otolaryngology Specialization: Sleep Medicine |
28760 | SC | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
28760 | SC | Allopathic & Osteopathic Physicians |
| Y | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
28760 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP5437 | 05 | |
| SC | FEDERAL DEA | DE5192 | 01 |
| Street Address |
1040 PINNACLE POINT DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-5735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194755314 | Chad B Gunnlaugsson | Otolaryngology | 1040 Pinnacle Point Dr, Columbia, SC 29223-5735 | 2006-07-04 |
| 1316063936 | Supriti Paul | Otolaryngology | 1040 Pinnacle Point Dr, Columbia, SC 29223-5735 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 207YX0602X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngic Allergy |
| An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245623792 | Black Creek Medical Consultants, LLC | Otolaryngology | 696 Medical Park Dr, Hartsville, SC 29550-4782 | 2015-03-09 |
| 1033185491 | Robert A Wilson | Otolaryngology | 4200 E North St Ste 16, Greenville, SC 29615-2437 | 2006-02-27 |
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| 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.