NPIMap

Organization Active NPI

Charleston ENT Associates LLC

Doing business as Beaufort ENT and Allergy

  • Otolaryngology Physician
  • Beaufort, SC
National Provider Identifier
1093237117
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CHARLESTON ENT ASSOCIATES LLC
Doing business as
Beaufort ENT and Allergy
Practice address
1231 Ribaut Rd
Beaufort, SC 29902-6147
Phone
(843) 525-6662
NPI assigned
Jul 11, 2017
Last updated
Jul 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CHARLESTON ENT ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Authorized official

Name
Eugene G Brown, MDNPI 1245238930
Title
President
Phone
(843) 766-7103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1231 Ribaut Rd
Beaufort, SC 29902-6147

Mailing address

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Other identifiers 1

IdentifierTypeStateIssuer
GP1728MedicaidSC

Other names 1

  • Beaufort ENT and Allergy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Charleston ENT Assoc LL13 organizations share this tax ID, including this one
Part of
Charleston ENT Assoc LL

Other organizations with this tax ID 12

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

Locations

1231 Ribaut Rd
Beaufort, SC 29902
Phone (843) 525-6622

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1093237117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "843-763-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026147",
            "telephone_number": "843-525-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON ENT ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLESTON ENT ASSOCIATES LLC",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-766-7103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1728",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort ENT and Allergy",
            "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 Jul 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.