NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • Specialist
  • Beaufort, SC
National Provider Identifier
1346474996
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
Beaufort Memorial Surgical Specialists
989 Ribaut Rd, Ste 360
Beaufort, SC 29902-5427
Phone
(843) 524-8171
Fax
(844) 296-2307
NPI assigned
May 12, 2009
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUFORT COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Mr. Edmond Russell Baxley III
Title
Ceo
Phone
(843) 522-5140

Specialties & licenses 1

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

Addresses

Primary practice location

Beaufort Memorial Surgical Specialists
989 Ribaut Rd, Ste 360
Beaufort, SC 29902-5427

Mailing address

955 Ribaut Road
Bmac Credentialing Coordinator
Beaufort, SC 29902-5441
Phone (843) 522-5674

Other practice location 1

Beaufort Memorial Surgical Specialists
11 Arley Way, Ste 201
Bluffton, SC 29910-4883
Phone (843) 524-8171

Other practice location 2

Beaufort Memorial Surgical Specialists
1000 Pine Street West
Varnville, SC 29944-0969
Phone (843) 524-8171

Other practice location 3

Beaufort Memorial Surgical Specialists
1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 524-8171

Other practice location 4

Beaufort Memorial Surgical Specialists-Okatie
122 Okatie Blvd N Ste 300
Okatie, SC 29909-3750
Phone (843) 524-8171

Other names 1

  • Beaufort Memorial Surgical Specialist Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518001061 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 141 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Varnville, SC; Port Royal, SC; Okatie, SC; Bluffton, SC; Beaufort, SC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Beaufort Memorial Hospital

Locations

1055 Ribaut Rd
Beaufort, SC 29902
Phone (843) 379-9933

990 Ribaut Rd
Ste 360
Beaufort, SC 29902

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1346474996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RIBAUT ROAD",
            "address_2": "BMAC CREDENTIALING COORDINATOR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "843-522-5674",
            "fax_number": "843-522-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEAUFORT MEMORIAL SURGICAL SPECIALISTS",
            "address_2": "989 RIBAUT RD, STE 360",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025427",
            "telephone_number": "843-524-8171",
            "fax_number": "844-296-2307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "BEAUFORT MEMORIAL SURGICAL SPECIALISTS",
            "address_2": "11 ARLEY WAY, STE 201",
            "address_purpose": "LOCATION",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104883",
            "country_code": "US",
            "telephone_number": "843-524-8171",
            "fax_number": "844-296-2307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "BEAUFORT MEMORIAL SURGICAL SPECIALISTS",
            "address_2": "1000 PINE STREET WEST",
            "address_purpose": "LOCATION",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299440969",
            "country_code": "US",
            "telephone_number": "843-524-8171",
            "fax_number": "844-296-2307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "BEAUFORT MEMORIAL SURGICAL SPECIALISTS",
            "address_2": "1680 RIBAUT RD",
            "address_purpose": "LOCATION",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "29935",
            "country_code": "US",
            "telephone_number": "843-524-8171",
            "fax_number": "844-296-2307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Beaufort Memorial Surgical Specialists-Okatie",
            "address_2": "122 Okatie Blvd N Ste 300",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299093750",
            "country_code": "US",
            "telephone_number": "843-524-8171",
            "fax_number": "844-296-2307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2009-05-12",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "BAXLEY",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-522-5140",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort Memorial Surgical Specialist",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Beaufort Memorial Surgical Specialist",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 21, 2020; 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.