NPIMap

Organization Active NPI

Acs Emergency Physicians of SC PC

  • Emergency Medicine Physician
  • Beaufort, SC
National Provider Identifier
1124355375
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ACS EMERGENCY PHYSICIANS OF SC PC
Practice address
955 Ribaut Rd
Beaufort, SC 29902-5441
Phone
(843) 522-5200
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Dr. Randal L. Dabbs, MD
Title
President
Phone
(865) 293-5210

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

955 Ribaut Rd
Beaufort, SC 29902-5441

Mailing address

14050 NW 14TH St Ste 190
Sunrise, FL 33323-2851
Phone (800) 424-3672

Other identifiers 1

IdentifierTypeStateIssuer
GP6079MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100114000254 SC Part B Supplier - Clinic/Group Practice 0648311506 Receives reassigned benefits from 53 practitioners
Practice locations: Beaufort, SC

National Provider Directory

National Provider Directory

Practitioners 99

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

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1124355375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 NW 14TH ST STE 190",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232851",
            "telephone_number": "800-424-3672",
            "fax_number": "954-377-3042"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACS EMERGENCY PHYSICIANS OF SC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "DABBS",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-293-5210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6079",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 15, 2019; 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.