Organization Active NPI

Sea Island Pediatrics

  • Pediatrics Physician
  • Beaufort, SC
National Provider Identifier
1295852085
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
00223 Issued in SC
Legal business name
SEA ISLAND PEDIATRICS
Practice address
2403 Allison Rd
Beaufort, SC 29902-5923
Phone
(843) 524-1078
NPI assigned
Mar 25, 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. Karen L. Keane, DO
Title
President
Phone
(843) 524-1078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 00223 SC Primary

Addresses

Primary practice location

2403 Allison Rd
Beaufort, SC 29902-5923

Mailing address

2403 Allison Rd
Beaufort, SC 29902-5923
Phone (843) 524-1078

Other identifiers 1

IdentifierTypeStateIssuer
GP3011MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295852085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 ALLISON RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025923",
            "telephone_number": "843-524-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 ALLISON RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025923",
            "telephone_number": "843-524-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA ISLAND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEANE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-524-1078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "00223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3011",
            "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 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.