NPIMap

Organization Active NPI

Beaufort Pediatrics, P.a.

  • Rural Health Clinic/Center
  • Beaufort, SC
National Provider Identifier
1720140825
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
12254 Issued in SC
Legal business name
BEAUFORT PEDIATRICS, P.A.
Practice address
964 Ribaut Rd
Beaufort, SC 29902-5429
Phone
(843) 524-5437
Fax
(843) 524-0425
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Dr. William D Martin III, MD
Title
President
Phone
(843) 524-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 12254 SC Primary

Addresses

Primary practice location

964 Ribaut Rd
Beaufort, SC 29902-5429

Mailing address

964 Ribaut Rd
Beaufort, SC 29902-5429
Phone (843) 524-5437

Other identifiers 1

IdentifierTypeStateIssuer
RHC156MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Beaufort Pediatrics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

964 Ribaut Rd
Beaufort, SC 29902
Phone (843) 524-5437

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1720140825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025429",
            "telephone_number": "843-524-5437",
            "fax_number": "843-524-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025429",
            "telephone_number": "843-524-5437",
            "fax_number": "843-524-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-524-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": "12254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC156",
            "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 Nov 11, 2024; 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.