MEDICARE: NOVANT HEALTH PATEWOOD SURGERY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1427901107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVANT HEALTH PATEWOOD SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	75 PATEWOOD DR STE 200
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-3518
Country	:	US
Telephone Number	:	336-277-8757
Fax Number	:	336-718-8916

Provider Business Practice Location Address
First Line	:	75 PATEWOOD DR STE 200
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-3518
Country	:	US
Telephone Number	:	336-277-8757
Fax Number	:	336-718-8916

Authorized Official
Title or Position	:	VP ASC OPERATIONS
Name	:	ANDREA SMITH-JONES
Credential	:
Telephone Number	:	336-277-8757

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/23/2026

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