BEAUFORT COUNTY MEMORIAL HOSPITAL (NPI# 1336180165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336180165 |
| Entity Type | Organization |
| Organization Name | BEAUFORT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BEAUFORT MEMORIAL LOWCOUNTRY MEDICAL GROUP |
| Practice Address |
Beaufort Memorial Lowcountry Medical Group 300 Midtown Beaufort SC 29906-5200 |
| Mailing Address |
955 Ribaut Rd Bmac Credentialing Beaufort SC 29902-5441 |
| Practice Telephone | 8437700404 |
| Practice Fax Number | 8442962308 |
| Mailing Telephone | 8435227843 |
| Mailing Fax Number | 8435225678 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | MR. EDMUND RUSSELL BAXLEY III (CEO) |
| Authorized Official Telephone | 8435225140 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEAUFORT COUNTY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID-TYPE UNSPECIFIED MEDICARE PART B | 3257 | 01 | |
| SC | GP6561 | 05 | |
| SC | 270920 | 05 | |
| SC | 101376 | 05 |
| Other Name | Type Code |
|---|---|
| Beaufort Memorial LowCountry Medical Group | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Beaufort Memorial Heart Specialists, 300 Midtown Drive, Beaufort, SC 299065200 | 8437700404 | 8442959872 |
| Beaufort Memorial Heart Specialists, 11 Arley Way, Ste 201, Bluffton, SC 299104883 | 8437700404 | 8442959872 |
| Beaufort Memorial Heart Specialists, 1000 Pine Street West, Varnville, SC 299440969 | 8437700404 | 8442959872 |
| Beaufort Memorial Oncology Specialists, 989 Ribaut Rd, Ste 310, Beaufort, SC 299025426 | 8435227350 | 8442962296 |
| Beaufort Memorial Lowcountry Medical Group, 11 Arley Way, Ste 201, Bluffton, SC 299104883 | 8437700404 | 8442962309 |
| Bmh Hospitalists, 955 Ribaut Rd, Beaufort, SC 299025441 | 8435225775 | |
| Beaufort Memorial Oncology Specialist-okatie, 122 Okatie Center Blvd N Ste 110, Okatie, SC 299093750 | 8435227350 | 8442962296 |
| Beaufort Memorial Heart Specialists-okatie, 122 Okatie Center Blvd N Suite 300, Okatie, SC 299093750 | 8437700404 | 8442959872 |
| Beaufort Memorial Lowcountry Medical Group (gi)-okatie, 122 Okatie Center Blvd N Ste 300, Okatie, SC 299093750 | 8437700404 | 8442962309 |
| 122 Okatie Center Blvd N Ste 100, Okatie, SC 299093750 | 8435227350 | 8442962296 |
| Beaufort Memorial Heart Specialists, 122 Okatie Center Blvd N Suite 302, Okatie, SC 299091003 | 8437700404 | 8442959872 |
| Beaufort Memorial Lowcountry Medical Group, 122 Okatie Center Blvd N Ste 302, Okatie, SC 299091003 | 8437700404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1619248317 | Beaufort County Memorial Hospital | Specialist | 990 Ribaut Rd Ste 210, Beaufort, SC 29902-8011 | 2012-01-26 |
| 1235430745 | Beaufort County Memorial Hospital | Internal Medicine | 1716 Ribaut Rd, Port Royal, SC 29935-1927 | 2010-11-15 |
| 1346474996 | Beaufort County Memorial Hospital | Specialist | Beaufort Memorial Surgical Specialists, 989 Ribaut Rd, Ste 360, Beaufort, SC 29902-5427 | 2009-05-12 |
| 1174769764 | Beaufort County Memorial Hospital | Radiology | 989 Ribaut Rd Ste 130, Beaufort, SC 29902 | 2009-01-02 |
| 1598713117 | Beaufort County Memorial Hospital | Internal Medicine | Beaufort Memorial Primary Care, 989 Ribaut Rd, Ste 260, Beaufort, SC 29902-5499 | 2006-05-05 |
| 1033175344 | Beaufort County Memorial Hospital | Physician Assistant | 1000 Pine Street West, Varnville, SC 29944-0969 | 2006-04-25 |
| 1366436073 | Beaufort County Memorial Hospital | General Acute Care Hospital | 955 Ribaut Rd, Beaufort, SC 29902-5441 | 2005-09-08 |
| 1992327845 | Beaufort County Memorial Hospital | Internal Medicine | 4818 Bluffton Pkwy, Bluffton, SC 29910-4602 | 2020-05-14 |
| 1235552746 | Beaufort County Memorial Hospital | Obstetrics & Gynecology | Beaufort Memorial Obstetrics & Gynecology Specialists, 989 Ribaut Rd, Ste 210, Beaufort, SC 29902-5472 | 2014-02-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEAUFORT COUNTY MEMORIAL HOSPITAL | 955 Ribaut Rd, Beaufort, SC 29902-5441 |
| Street Address |
BEAUFORT MEMORIAL LOWCOUNTRY MEDICAL GROUP 300 MIDTOWN |
| City | BEAUFORT |
| State | SC |
| Zip Code | 29906-5200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285673327 | James A Swenson | Specialist | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-06-05 |
| 1801269303 | Margaret Tanner Miler | Physician Assistant | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Dr, Beaufort, SC 29906-5200 | 2015-11-05 |
| 1417342247 | Emi Michelle Rendon Pope | Internal Medicine | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906 | 2015-03-30 |
| 1144599929 | Erin Royal Scott | Nurse Practitioner | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2011-12-22 |
| 1336300078 | Kristen C Johnson | Physician Assistant | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2008-06-24 |
| 1942370200 | John Craig Floyd | Family Medicine | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-11-08 |
| 1720158843 | John Crisologo | Internal Medicine | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-11-08 |
| 1932279197 | Richard Preston Stewart | Internal Medicine | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Dr, Beaufort, SC 29906-5200 | 2006-11-08 |
| 1083784110 | Fletcher Carl Derrick IIi | Internal Medicine | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Dr, Beaufort, SC 29906-5200 | 2006-11-08 |
| 1508936774 | Eve Anne Ashby | Obstetrics & Gynecology | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376038687 | Derek Ray Dawson | Dentist | 74 Shadow Moss Dr, Beaufort, SC 29906 | 2018-06-28 |
| 1275957821 | Alan F Dinehart Jr. | Chiropractor | 30 Robert Smalls Parkway, Beaufort, SC 29906 | 2014-02-18 |
| 1699019414 | Poimen,llc | Non-emergency Medical Transport (VAN) | 75 Stanley Farm Road, Beaufort, SC 29906 | 2012-11-16 |
| 1104157569 | Jennifer L Williams | Marriage & Family Therapist | 69 Robert Smalls Pkwy Ste 2b, Beaufort, SC 29906 | 2010-01-26 |
| 1437395969 | Heather L Coker | Counselor | 62 Possum Hill Rd, Beaufort, SC 29906 | 2009-01-06 |
| 1750532115 | Sailaja Adari | Internal Medicine | 300 Mid Town Drive, Beaufort, SC 29906 | 2008-10-03 |
| 1245443241 | A Community Caring for Children | Dental Hygienist | 120 Shanklin Road, Beaufort, SC 29906 | 2007-05-07 |
| 1871672485 | Cathy Lorraine Bagley | Obstetrics & Gynecology | 330 Robert Smalls Pkwy Ste 24-344, Beaufort, SC 29906 | 2006-11-03 |
| 1073521662 | Bertram Dodson Garrett | Family Medicine | 10 Fort Lyttleton, Beaufort, SC 29906 | 2006-08-03 |
| 1568401099 | Lee O Butterfield | Internal Medicine | Beaufort Memorial Heart Specialist, 300 Midtown Dr, Beaufort, SC 29906 | 2006-06-06 |
| Find all providers in zip 29906 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336539758 | James Connelly | General Practice | Geiger Blvd Building 598, Beaufort, SC 29904 | 2015-01-24 |
| 1346637949 | Henry Markley Gass Iv | General Practice | Geiger Blvd Building 598, Beaufort, SC 29904 | 2015-04-21 |
| 1558340570 | William Buske Nguyen | General Practice | 1 Pinckney Blvd Naval Hospital Beaufort, Attn Professional Affairs Coordinator, Beaufort, SC 29902-6148 | 2006-01-10 |
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|---|---|---|---|---|
| 1053912253 | Life Essentials Health Center LLC | General Practice | 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464-3342 | 2020-11-04 |
| 1710591706 | Madhuri Khadka | General Practice | 427 Galbreath Ct, Fort Mill, SC 29708-0176 | 2020-09-07 |
| 1255945754 | Escobedo Advanced Healthcare Solutions LLC | General Practice | 121 Sparkleberry Crossing Rd Ste 200, Columbia, SC 29229-8639 | 2020-09-02 |
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1841704244 | Modern Concepts, LLC | General Practice | 1808 Second Baxter Xing Ste 108, Fort Mill, SC 29708 | 2017-11-21 |
| 1245744937 | Carolina Healthchoice of Greenville, LLC | General Practice | 274 Commonwealth Dr Ste B, Greenville, SC 29615-4872 | 2017-11-17 |
| 1861937377 | Doctors Care Sc, Pa | General Practice | 8384 Charlotte Highway, Indian Land, SC 29707-6532 | 2016-12-20 |
| 1790138014 | Beaufort-jasper-hampton Comprehensive Health Services Inc. | General Practice | 2210-b Mossy Oaks Rd., Port Royal, SC 29935-1046 | 2016-07-21 |
| 1659726438 | Inspire Medical Services | General Practice | 104 Berkeley Square Ln, Ste 63, Goose Creek, SC 29445-2958 | 2016-04-28 |
| 1609240910 | Eating Recovery Center-the Carolinas | General Practice | 12 Maple Tree Court, Suite 101, Greenville, SC 29615-4079 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
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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.