NPIMap

Organization Active NPI

Ralph H. Johnson VA Medical Center

  • Surgery Physician
  • Beaufort, SC
National Provider Identifier
1558377887
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5601 Issued in SC
Legal business name
RALPH H. JOHNSON VA MEDICAL CENTER
Practice address
1 Pinckney Blvd
Beaufort VA Primary Care Clinic
Beaufort, SC 29902-6122
Phone
(843) 770-0444
Fax
(843) 770-0808
NPI assigned
Jul 31, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jamie Cady
Title
MCCR Supervisor
Phone
(843) 789-6352

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5601 SC Primary

Addresses

Primary practice location

1 Pinckney Blvd
Beaufort VA Primary Care Clinic
Beaufort, SC 29902-6122

Mailing address

1 Pinckney Blvd
PO Box 6038-B
Beaufort, SC 29902-6122
Phone (843) 770-0444

National Provider Directory

National Provider Directory
Tax ID family
Ralph H Johnson Vamc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 1

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1558377887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "address_2": "PO BOX 6038-B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026122",
            "telephone_number": "843-770-0444",
            "fax_number": "843-770-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "address_2": "BEAUFORT VA PRIMARY CARE CLINIC",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026122",
            "telephone_number": "843-770-0444",
            "fax_number": "843-770-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH H. JOHNSON VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CADY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "MCCR SUPERVISOR",
        "authorized_official_telephone_number": "843-789-6352"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "5601",
            "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 21, 2022; 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.