NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • General Acute Care Hospital
  • Beaufort, SC
National Provider Identifier
1063596443
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
955 Ribaut Rd
Beaufort, SC 29902-5441
Phone
(843) 522-5200
Fax
(843) 522-5765
NPI assigned
Oct 24, 2006
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 6

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

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000354 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 229 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaufort, SC; Okatie, SC; Varnville, SC

National Provider Directory

National Provider Directory
Tax ID family
Sea Island Cancer Center (16 organizations share this tax ID)

Locations

122 Okatie Center Blvd N
Ste 300
Okatie, SC 29909
Phone (843) 707-8040

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

955 Ribaut Rd
Beaufort, SC 29902-5441

Mailing address

955 Ribaut Road
Bmac Credentialing Coordinator
Beaufort, SC 29902-5441
Phone (843) 522-5674

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
400676MedicaidSC

Other names 1

NPPES NPI Registry
  • Beaufort Memorial Hospital Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2020.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1063596443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RIBAUT ROAD",
            "address_2": "BMAC CREDENTIALING COORDINATOR",
            "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": "955 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "843-522-5200",
            "fax_number": "843-522-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400676",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaufort Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.