Hilton Head Regional Physician Group LLC
Organization Active NPI Surgery Physician · Bluffton, SC
NPI 1295596708 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1295596708
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- HILTON HEAD REGIONAL PHYSICIAN GROUP LLC
- Practice address
- 75 Baylor Dr Ste 190
Bluffton, SC 29910-8965 - Phone
- (843) 689-1326
- Fax
- (843) 706-3197
- NPI assigned
- Jan 22, 2024
- Organization subpart
- No
Authorized official
- Name
- Doreatha Rogers
- Title
- RCS Manager
- Phone
- (980) 302-7992
Other NPIs on the same Medicare enrollment 38
Corporate family (same tax ID) 24
Practitioners 162
-
Timothy James Alikakos, M.D.
-
Mallory Hudson Alkis, M.D.
-
Luann Aquino, MD
-
Brittany Austin, MD
-
Matthew Baker, PHARMD, PA-C
-
Norman Bettle, M.D.
-
Edward Riley Blocker, M.D.
-
Jimena C Burnett, MD
-
Eugene Y Chang, MD.
-
Anton M Clemmons, M.D.
-
Carlos A Cordero, M.D.
-
Jacey Cornett, PA-C
-
Jason William Cotter, M.D.
-
Joann Csakany, MD
-
Jaime Cuff, APRN
-
Kyle D'Amato, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2077843 | Novant Health Wound Healing Center- Bluffton Dba | Certificate of waiver | Aug 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240214000643 | SC | Part B Supplier - Clinic/Group Practice | 9234573676 |
Receives reassigned benefits from 173 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Okatie, SC; Hilton Head Island, SC; Hilton Head, SC; Hardeeville, SC; Beaufort, SC; Bluffton, SC; Hampton, SC |
National Provider Directory
- Tax ID family
- Hilton Head Regional Physician Group LLC
Locations
13 Marshellen Dr
Beaufort, SC 29902
Phone (843) 521-0377
75 Baylor Dr
Ste 190
Bluffton, SC 29910
Phone (843) 689-1326
8 Hospital Center Blvd
Ste 110
Hilton Head Island, SC 29926
Phone (843) 681-4771
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
75 Baylor Dr Ste 190
Bluffton, SC 29910-8965
Mailing address
PO Box 37643
Belfast, ME 04915-1218
Other names
- Wound Healing Center
Other providers in Bluffton, SC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
- Hilton Head Regional Physician Group LLC
All providers in Bluffton, SC · Surgery Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.