NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • Addiction Medicine (Internal Medicine) Physician
  • Beaufort, SC
National Provider Identifier
1457922007
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
989 Ribaut Rd Ste 370
Beaufort, SC 29902-5472
Phone
(843) 522-7290
Fax
(843) 470-1381
NPI assigned
Jul 6, 2021
Last updated
Jul 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Trimmell S Simmons
Title
Medical Staff Coordinator
Phone
(843) 522-5790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X NU Primary

Addresses

Primary practice location

989 Ribaut Rd Ste 370
Beaufort, SC 29902-5472

Mailing address

955 Ribaut Rd
Beaufort, SC 29902-5441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000354 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 229 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaufort, SC; Okatie, SC; Varnville, SC

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Beaufort Co Mem Hospita16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1457922007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 RIBAUT RD STE 370",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025472",
            "telephone_number": "843-522-7290",
            "fax_number": "843-470-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TRIMMELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL STAFF COORDINATOR",
        "authorized_official_telephone_number": "843-522-5790"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "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 Jul 6, 2021; 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.