Individual provider Active NPI

Glenn L Werner, MD

  • Obstetrics & Gynecology Physician
  • Beaufort, SC
National Provider Identifier
1871548479
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
15977 Issued in SC
Practice address
1264 Ribaut Road
BLDG 200
Beaufort, SC 29902
Phone
(843) 524-5455
Fax
(843) 524-5655
NPI assigned
May 23, 2006
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 15977 SC Primary

Addresses

Primary practice location

1264 Ribaut Road
BLDG 200
Beaufort, SC 29902

Mailing address

PO Box 357
Ridgeland, SC 29936-2605
Phone (843) 987-7400

Other identifiers 1

IdentifierTypeStateIssuer
GP3884MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000009 SC Practitioner - Obstetrics/Gynecology 0143110908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wake Forest University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

721 Okatie Hwy
Okatie, SC 29909-3963
Phone (843) 987-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc CurrentSince Feb 1, 2020 Accepting new patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Feb 1, 2020 Accepting new patients
Hilton Head Internists, LLC Past Accepting new patients

Locations

1264 Ribaut Rd
Ste 200
Beaufort, SC 29902
Phone (843) 524-2466

721 Okatie Hwy
Okatie, SC 29909

721 N Okatie Hwy
#170
Ridgeland, SC 29936

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16904/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1871548479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299362605",
            "telephone_number": "843-987-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT ROAD",
            "address_2": "BLDG 200",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-524-5455",
            "fax_number": "843-524-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "GLENN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "15977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3884",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.