NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • Orthopaedic Surgery Physician
  • Port Royal, SC
National Provider Identifier
1053647164
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
1680 Ribaut Rd
Port Royal, SC 29935-2008
Phone
(843) 524-3015
Fax
(844) 296-2306
NPI assigned
Oct 23, 2009
Last updated
Jul 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUFORT COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Mr. Edmond Russell Baxley III
Title
Ceo
Phone
(843) 522-5140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1680 Ribaut Rd
Port Royal, SC 29935-2008

Mailing address

300 Midtown Dr
Beaufort, SC 29906-5200
Phone (843) 522-5200

Other names 1

  • Beaufort Memorial Orthopaedic Specialists Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518001061 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 141 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Varnville, SC; Port Royal, SC; Okatie, SC; Bluffton, SC; Beaufort, SC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Beaufort Mem Hosp

Locations

300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746

989 Ribaut Rd
Ste 260
Beaufort, SC 29902
Phone (843) 522-7600

1 Burnt Church Rd
#B
Bluffton, SC 29910
Phone (843) 706-2287

Practitioners & affiliated clinicians

Practitioners 136

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1053647164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MIDTOWN DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299065200",
            "telephone_number": "843-522-5200",
            "fax_number": "843-322-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352008",
            "telephone_number": "843-524-3015",
            "fax_number": "844-296-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2009-10-23",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BAXLEY",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-522-5140",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort Memorial Orthopaedic Specialists",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Beaufort Memorial Orthopaedic Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Royal, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.