NPIMap

Organization Active NPI

Ribaut Medical Partners, LLC

  • Primary Care Clinic/Center
  • Beaufort, SC
National Provider Identifier
1750800520
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD22623 Issued in SC
Legal business name
RIBAUT MEDICAL PARTNERS, LLC
Practice address
1094 Ribaut Rd
Beaufort, SC 29902-5437
Phone
(843) 524-2001
NPI assigned
Sep 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Samuel Clark Trask, MDNPI 1730160896
Title
Owner
Phone
(843) 524-2001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD22623 SC Primary

Addresses

Primary practice location

1094 Ribaut Rd
Beaufort, SC 29902-5437

Mailing address

PO Box 2329
Beaufort, SC 29901-2329
Phone (843) 524-2001

Other identifiers 3

IdentifierTypeStateIssuer
11363059OtherCAQH
22623OtherSCMEDICAL LICENSE
266232MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171129002791 SC Part B Supplier - Clinic/Group Practice 4688931686 Receives reassigned benefits from 2 practitioners
Practice locations: Beaufort, SC

National Provider Directory

National Provider Directory
Tax ID family
Ribaut Medical Partners2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1750800520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2329",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299012329",
            "telephone_number": "843-524-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025437",
            "telephone_number": "843-524-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIBAUT MEDICAL PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "TRASK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-524-2001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "MD22623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11363059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "22623",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266232",
            "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 Mar 7, 2023; 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.