Individual provider Active NPI

Lawrence R Coleman, M.D.

  • Pediatrics Physician
  • Beaufort, SC
National Provider Identifier
1912962630
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12282 Issued in SC
Practice address
964 Ribaut Rd Ste 1
Beaufort, SC 29902-5425
Phone
(843) 524-5437
Fax
(843) 524-0425
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12282 SC Primary

Addresses

Primary practice location

964 Ribaut Rd Ste 1
Beaufort, SC 29902-5425

Mailing address

964 Ribaut Rd
Suite 1
Beaufort, SC 29902-5429
Phone (843) 524-7833

Other practice location 1

Beaufort Memorial Express Care & Occupational Health
974 Ribaut Rd
Beaufort, SC 29902-5486
Phone (843) 524-3344

Other identifiers 1

IdentifierTypeStateIssuer
122824MedicaidSC

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
I20190416002470 SC Practitioner - Pediatric Medicine 7911928247 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Jun 11, 2019 Accepting new patients
Beaufort County Memorial Hospital Current Accepting new patients
Beaufort County Memorial Hospital CurrentSince Jun 11, 2019 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Jun 11, 2019 Accepting new patients

Locations

989 Ribaut Rd
Ste 260
Beaufort, SC 29902
Phone (843) 522-7600

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

974 Ribaut Rd
Beaufort, SC 29902
Phone (843) 524-3344

300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

955 Ribaut Rd
#C
Beaufort, SC 29902

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1912962630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 RIBAUT RD",
            "address_2": "SUITE 1",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025429",
            "telephone_number": "843-524-7833",
            "fax_number": "843-524-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 RIBAUT RD STE 1",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025425",
            "telephone_number": "843-524-5437",
            "fax_number": "843-524-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "BEAUFORT MEMORIAL EXPRESS CARE & OCCUPATIONAL HEALTH",
            "address_2": "974 RIBAUT RD",
            "address_purpose": "LOCATION",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025486",
            "country_code": "US",
            "telephone_number": "843-524-3344",
            "fax_number": "844-295-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "LAWRENCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "12282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122824",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.