NPIMap

Organization Active NPI

Glenn L. Werner, M.D. PC

  • Specialist
  • Beaufort, SC
National Provider Identifier
1194873943
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15977 Issued in SC
Legal business name
GLENN L. WERNER, M.D. PC
Practice address
1264 Ribaut Rd
Building 200
Beaufort, SC 29902-6123
Phone
(843) 524-5455
Fax
(843) 524-5655
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Glenn L Werner, M.D.
Title
Owner
Phone
(843) 524-5455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 15977 SC Primary

Addresses

Primary practice location

1264 Ribaut Rd
Building 200
Beaufort, SC 29902-6123

Mailing address

1264 Ribaut Rd
Building 200
Beaufort, SC 29902-6123
Phone (843) 524-5455

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194873943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT RD",
            "address_2": "BUILDING 200",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026123",
            "telephone_number": "843-524-5455",
            "fax_number": "843-524-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT RD",
            "address_2": "BUILDING 200",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026123",
            "telephone_number": "843-524-5455",
            "fax_number": "843-524-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN L. WERNER, M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-524-5455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "15977",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.