NPIMap

Organization Active NPI

Beaufort Jasper Hampton Comprehensive Health Services Inc.

Doing business as Port Royal Medical Center II

  • Federally Qualified Health Center (FQHC)
  • Port Royal, SC
National Provider Identifier
1790138014
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES INC.
Doing business as
Port Royal Medical Center II
Practice address
2210-B Mossy Oaks Rd.
Port Royal, SC 29935-1046
Phone
(843) 986-0900
NPI assigned
Jul 21, 2016
Last updated
May 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Mr. Roland J Gardner
Title
Chief Executive Officer
Phone
(843) 987-7400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

2210-B Mossy Oaks Rd.
Port Royal, SC 29935-1046

Mailing address

721 N Okatie Hwy
Ridgeland, SC 29936-8276
Phone (874) 987-7400

Other names 1

  • Port Royal Medical Center II Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161228000779 SC Part A Provider - Federally Qualified Health Center (FQHC) 5597675728 Practice locations: Port Royal, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790138014. Details of each certification follow.

Federally qualified health center certification: CCN 421047

Legal name
BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES INC
Doing business as
PORT ROYAL MEDICAL CENTER II
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 17, 2017
Last certification
Jan 17, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 8, 1970 in SC
Enrollment address
2210-B Mossy Oaks Road
Port Royal, SC 29935-1046

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
York Glover Individual Corporate OfficerBoard Member May 23, 2013
Jamie Hunter Individual W-2 Managing EmployeeMD; Jul 5, 2024
Natassia Allen Individual W-2 Managing EmployeeChief Operations Officer Aug 12, 2025
Melissa Major Individual Corporate OfficerChief Finance Office Dec 9, 2024
W-2 Managing EmployeeChief Finance Officer Dec 9, 2024
Operational/Managerial Control Dec 9, 2024
Faith Lawrence Polkey Individual Corporate OfficerChief Executive Officer Apr 17, 2022
W-2 Managing EmployeeChief Executive Officer Apr 17, 2022
Operational/Managerial ControlChief Executive Officer Apr 17, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Port Royal Medical CenterPort Royal, SC, CCN 421915 Federally qualified health center Operational/Managerial Control Sep 21, 2009
Leroy E. Browne Medical CenterSaint Helena Island, SC, CCN 421911 Federally qualified health center Operational/Managerial Control Sep 21, 2009
Bjhchs, IncHampton, SC, CCN 421910 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 21, 2009
Bjhchs, IncHardeeville, SC, CCN 421912 Federally qualified health center Operational/Managerial Control Sep 21, 2009
Elijah Washington Medical CenterSheldon, SC, CCN 421908 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 21, 2009
Sep 21, 2009
Estill Medical CenterEstill, SC, CCN 421907 Federally qualified health center 5% Or Greater Security Interest (100%) Nov 29, 2012
Varnville Medical CenterVarnville, SC, CCN 421116 Federally qualified health center Operational/Managerial Control (100%) Mar 31, 2025
Bjhchs Mobile UnitOkatie, SC, CCN 421131 Federally qualified health center Operational/Managerial Control Nov 3, 2025

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1790138014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N OKATIE HWY",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299368276",
            "telephone_number": "874-987-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210-B MOSSY OAKS RD.",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351046",
            "telephone_number": "843-986-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-987-7400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Royal Medical Center II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Royal Medical Center II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Royal, SC

Sources for this page

Verify at the official NPI Registry.