NPIMap

Organization Active NPI

Beaufort Memorial Hospital

  • Family Medicine Physician
  • Hardeeville, SC
National Provider Identifier
1174786339
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BEAUFORT MEMORIAL HOSPITAL
Practice address
1010 Medical Center Dr
Suite 240
Hardeeville, SC 29927-3447
Phone
(843) 784-8300
Fax
(843) 784-8304
NPI assigned
Jul 8, 2008
Organization subpart
Yes
Parent organization
BEAUFORT MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Authorized official

Name
Jeff White
Title
SVP/Cfo
Phone
(843) 522-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1010 Medical Center Dr
Suite 240
Hardeeville, SC 29927-3447

Mailing address

989 Ribaut Rd
Suite 260
Beaufort, SC 29902-5472
Phone (843) 522-7600

Other identifiers 1

IdentifierTypeStateIssuer
GP2570MedicaidSC

Other names 1

  • Coastal Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sea Island Cancer Center16 organizations share this tax ID, including this one
Part of
Sea Island Cancer Center

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1174786339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 RIBAUT RD",
            "address_2": "SUITE 260",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025472",
            "telephone_number": "843-522-7600",
            "fax_number": "843-522-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MEDICAL CENTER DR",
            "address_2": "SUITE 240",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273447",
            "telephone_number": "843-784-8300",
            "fax_number": "843-784-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUFORT MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SVP/CFO",
        "authorized_official_telephone_number": "843-522-5200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2570",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hardeeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.