NPIMap

Organization Active NPI

Beaufort County Memorial Hospital

  • Internal Medicine Physician
  • Bluffton, SC
National Provider Identifier
1992327845
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Practice address
4818 Bluffton Pkwy
Bluffton, SC 29910-4602
Phone
(843) 706-0600
NPI assigned
May 14, 2020
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUFORT COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Mr. Ken Miller
Title
Cfo
Phone
(843) 522-5142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

4818 Bluffton Pkwy
Bluffton, SC 29910-4602

Mailing address

4818 Bluffton Pkwy
Bluffton, SC 29910-4602
Phone (843) 706-0600

Other names 1

  • Beaufort Memorial Palmetto Medical Group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604000537 SC Part B Supplier - Clinic/Group Practice 7810809365 Receives reassigned benefits from 9 practitioners
Practice locations: Bluffton, SC

Other NPIs with the same Medicare PAC ID 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1090136Beaufort County Memorial Hospital Dba4818 Bluffton Parkway, Bluffton, SC 29910Certificate of waiverOct 2, 2026

National Provider Directory

National Provider Directory
Part of
Beaufort Mem Hosp

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 10

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": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1992327845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4818 BLUFFTON PKWY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104602",
            "telephone_number": "843-706-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 BLUFFTON PKWY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104602",
            "telephone_number": "843-706-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUFORT COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-522-5142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort Memorial Palmetto Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.