NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • Pulmonary Disease Physician
  • Okatie, SC
National Provider Identifier
1831764927
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
Beaufort Memorial Pulmonary Specialist
122 Okatie Center Blvd N Ste 300
Okatie, SC 29909-3782
Phone
(843) 522-5775
NPI assigned
May 21, 2021
Last updated
May 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 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
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

Beaufort Memorial Pulmonary Specialist
122 Okatie Center Blvd N Ste 300
Okatie, SC 29909-3782

Mailing address

Beaufort County Memorial Hospital
955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210721002246 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 9 practitioners
Practice locations: Beaufort, SC; Okatie, SC

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Beaufort Mem Hosp16 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

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Beaufort County Memorial HospitalBeaufort, SC, CCN 420067 Hospital Operational/Managerial Control Apr 3, 2017

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1831764927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
            "address_2": "955 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025441",
            "telephone_number": "843-522-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEAUFORT MEMORIAL PULMONARY SPECIALIST",
            "address_2": "122 OKATIE CENTER BLVD N STE 300",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299093782",
            "telephone_number": "843-522-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-07",
        "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": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okatie, SC

Sources for this page

Verify at the official NPI Registry.