BEAUFORT COUNTY MEMORIAL HOSPITAL (NPI# 1346474996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346474996 |
Entity Type | Organization |
Organization Name | BEAUFORT COUNTY MEMORIAL HOSPITAL |
Other Organization Name | BEAUFORT MEMORIAL SURGICAL SPECIALIST |
Practice Address |
Beaufort Memorial Surgical Specialists 989 Ribaut Rd, Ste 360 Beaufort SC 29902-5427 |
Mailing Address |
955 Ribaut Road Bmac Credentialing Coordinator Beaufort SC 29902-5441 |
Practice Telephone | 8435248171 |
Practice Fax Number | 8442962307 |
Mailing Telephone | 8435225674 |
Mailing Fax Number | 8435225678 |
Enumeration Date | 2009-05-12 |
Last Update Date | 2020-10-21 |
Authorized Official Name | MR. EDMOND 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 | 174400000X | Specialist | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | US DEPT OF LABOR | 155666800 | 01 |
SC | CLIA | 42D0957596 | 01 |
SC | BCBSSC | 1346474996 | 01 |
SC | GP8668 | 05 |
Other Name | Type Code |
---|---|
Beaufort Memorial Surgical Specialist | Other Name - Individual/Organization |
Address | Telephone Number | Fax Number |
---|---|---|
1055 Ribaut Rd, Suite 30, Beaufort, SC 299025423 | 8435248171 | 8435256613 |
989 Ribaut Rd Ste 360, Beaufort, SC 299025427 | 8435248171 | 8442962307 |
Beaufort Memorial Surgical Specialists, 11 Arley Way, Ste 201, Bluffton, SC 299104883 | 8435248171 | 8442962307 |
Beaufort Memorial Surgical Specialists, 1680 Ribaut Rd, Port Royal, SC 29935 | 8435248171 | 8442962307 |
Beaufort Memorial Surgical Specialists, 1000 Pine Street West, Varnville, SC 299440969 | 8435248171 | 8442962307 |
Beaufort Memorial Surgical Specialists-bluffton, 122 Okatie Blvd N Ste 302, Okatie, SC 299091003 | 8435248171 | |
Beaufort Memorial Surgical Specialists-okatie, 122 Okatie Blvd N Ste 300, Okatie, SC 299093750 | 8435248171 | 8442962307 |
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 |
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 |
1013224989 | Beaufort County Memorial Hospital | Clinic/Center | 989 Ribaut Rd, Ste. 240, Beaufort, SC 29902-5472 | 2010-09-13 |
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 SURGICAL SPECIALISTS 989 RIBAUT RD, STE 360 |
City | BEAUFORT |
State | SC |
Zip Code | 29902-5427 |
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 |
1750992475 | Fayth Polite | Social Worker | 2210 Salem Drive East, Beaufort, SC 29902 | 2020-08-14 |
1417509530 | Andrew Grant Miner | Dentist | Naval Hospital Beaufort, 1 Pinckney Blvd., Fpo, AA 29902 | 2019-07-09 |
1376029777 | Edward Dela Fuente | Counselor | Coastal Empire Mental Health Center, 1050 Ribaut Road, Beaufort, SC 29902 | 2018-07-18 |
1114440419 | Kristin Webb | Registered Nurse | 607 Wilmington Street, Beaufort, SC 29902 | 2017-07-19 |
1326582081 | Annemarie Gierling Gault | Nurse Practitioner | Beaufort Memorial Medical Oncology Infusion Center, 989 Ribaut Rd, Ste 103, Beaufort, SC 29902 | 2016-12-14 |
1114396579 | Jacquelyn Faith Proulx | Dentist | 1 Pickney Blvd., Naval Hospital Beaufort, Beaufort, SC 29902 | 2015-09-16 |
1386028413 | Howard Family Dental - Beaufort, Pllc | Dentist | 35 Robert Smalls Pkwy, Beaufort, SC 29902 | 2015-07-18 |
1598018103 | Lisa Marie Johnson | Occupational Therapist | 9555 Ribaut Road, Beaufort Memorial Hospital, Beaufort, SC 29902 | 2012-10-19 |
1134497860 | Jeremy Michael Simmons | Pharmacist | 2127 Boundary Street, Suite 19, Beaufort, SC 29902 | 2011-12-08 |
Find all providers in zip 29902 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
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. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801217831 | Shardae Bartley | Specialist | 301 Carteret St, Beaufort, SC 29902-5525 | 2013-12-17 |
1619248317 | Beaufort County Memorial Hospital | Specialist | 990 Ribaut Rd Ste 210, Beaufort, SC 29902-8011 | 2012-01-26 |
1336462894 | Cynthia Allison-simpkins | Specialist | 90 Marsh Dr, Beaufort, SC 29907-1354 | 2010-03-11 |
1417008459 | Beaufort Gastroenterology | Specialist | 989 Ribaut Rd Ste 300, Beaufort, SC 29902-5426 | 2007-01-16 |
1477618189 | Coastal Obstetrics and Gynecology | Specialist | 13 Marshellen Drive, Beaufort, SC 29902 | 2006-12-22 |
1275618332 | Palmetto Pain Center Pa | Specialist | 41 Marshellen Dr, Suite A, Beaufort, SC 29902-6900 | 2006-10-26 |
1154365575 | Evan C Reese Jr. | Specialist | 1251 B Ribaut Rd, Beaufort, SC 29902 | 2006-06-15 |
1285673327 | James A Swenson | Specialist | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Drive, Beaufort, SC 29906-5200 | 2006-06-05 |
1205888765 | Karen Michelle Eller | Specialist | 41a Marshellen Dr, Palmetto Pain Pa, Beaufort, SC 29902-6900 | 2006-05-16 |
1831175694 | Moore Surgical and Women's Healthcare Associates, Pa | Specialist | 990 Ribaut Rd, Suite 102, Beaufort, SC 29902-5601 | 2005-12-22 |
Find all providers in BEAUFORT |
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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.