Kurt Richard Ellenberger, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19453 Issued in SC

Practice address

Beaufort Memorial Express Care & Occupational Health
974 Ribaut Rd
Beaufort, SC 29902

Phone

(843) 524-3344

Fax

(844) 295-9894

NPI assigned

Apr 19, 2006

Last updated

May 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kurt.ellenberger.1@16436.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beaufort County Memorial Hospital

  • Internal Medicine Physician
  • Beaufort, SC
  • NPI 1598713117
  Medicare reassignment NPD
• Beaufort County Memorial Hospital

  dba Beaufort Memorial Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Beaufort, SC
  • NPI 1871335018
  Medicare reassignment NPD
• Beaufort County Memorial Hospital

  • Orthopaedic Surgery Physician
  • Port Royal, SC
  • NPI 1053647164
  NPD
• Beaufort County Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Beaufort, SC
  • NPI 1235552746
  NPD
• Beaufort County Memorial Hospital

  • General Acute Care Hospital
  • Beaufort, SC
  • NPI 1366436073
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1053376111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RIBAUT RD",
            "address_2": "BMAC CREDENTIALING",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "843-522-5674",
            "fax_number": "843-522-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEAUFORT MEMORIAL EXPRESS CARE & OCCUPATIONAL HEALTH",
            "address_2": "974 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-524-3344",
            "fax_number": "844-295-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERGER",
        "first_name": "KURT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "19453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194532",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LICENSE BOARD",
            "identifier": "19453",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clara Grace Edwards, RBT
• Kimberly Edwards
• Michael Charles Edwards Jr., DPM
• Lori Elias
• Jessica Elkins
• Karen Eller, M.D.
• Lonnie E Elliott, L.P.C.
• Emerge Counseling & Art Therapy
• Kevin Usif Ennis, A.T.,C.
• Daniel Estigoy, PA

• Pediatrics Physician in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.