BEAUFORT MEMORIAL SURGICAL SPECIALIST
NPI 1346474996
Specialist in Beaufort, SC

NPI Status: Active since May 12, 2009

Contact Information

BEAUFORT MEMORIAL SURGICAL SPECIALISTS
989 RIBAUT RD, STE 360
BEAUFORT, SC
ZIP 29902
Phone: (843) 524-8171
Fax: (844) 296-2307

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  • Organization
  • Specialist
  • Accepts Insurance
  • CLIA Number: 42D2305441
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-30-2028

About BEAUFORT MEMORIAL SURGICAL SPECIALIST

This page provides the complete NPI Profile along with additional information for Beaufort Memorial Surgical Specialist, a provider established in Beaufort, South Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1346474996 assigned on May 2009. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's other name is Beaufort Memorial Surgical Specialist. The authorized official of this NPI record is Mr. Edmond Russell Baxley Iii (Ceo)

NPI
1346474996
Provider Legal Name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Other Organization Name
BEAUFORT MEMORIAL SURGICAL SPECIALIST
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
BEAUFORT MEMORIAL SURGICAL SPECIALISTS 989 RIBAUT RD, STE 360 BEAUFORT, SC 29902
Location Phone
(843) 524-8171
Location Fax
(844) 296-2307
Mailing Address
955 RIBAUT ROAD BMAC CREDENTIALING COORDINATOR BEAUFORT, SC 29902
Mailing Phone
(843) 522-5674
Mailing Fax
(844) 296-2307
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
05-12-2009
Last Update Date
10-21-2020
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Location Map

Secondary Locations

  • BEAUFORT MEMORIAL SURGICAL SPECIALISTS 1000 PINE STREET WEST
    VARNVILLE, SC 29944
    (843) 524-8171
  • BEAUFORT MEMORIAL SURGICAL SPECIALISTS 11 ARLEY WAY, STE 201
    BLUFFTON, SC 29910
    (843) 524-8171
  • BEAUFORT MEMORIAL SURGICAL SPECIALISTS 1680 RIBAUT RD
    PORT ROYAL, SC 29935
    (843) 524-8171
  • Beaufort Memorial Surgical Specialists-Okatie 122 Okatie Blvd N Ste 300
    Okatie, SC 29909
    (843) 524-8171

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Blue Beaufort Bronze 1 - HMO
  • Blue Beaufort Bronze 2 - HMO
  • Blue Beaufort Gold 1 - HMO
  • Blue Beaufort Silver 1 - HMO
  • Blue Beaufort Silver 2 - HMO
  • Blue Beaufort Silver 2 + Adult Vision - HMO
  • Blue Beaufort Standard Expanded Bronze - HMO
  • Blue Beaufort Standard Gold - HMO
  • Blue Beaufort Standard Silver - HMO
  • Blue Direction Bronze 1 - POS
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Gold Value - HMO
  • Molina Gold Value Plus with Adult Dental and Vision - HMO
  • Molina Gold Value Plus with Adult Vision - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. EDMOND RUSSELL BAXLEY III

Authorized Official Title
CEO
Authorized Official Phone
(843) 522-5140

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
155666800OTHER (01)SCUS DEPT OF LABOR
42D0957596OTHER (01)SCCLIA
1346474996OTHER (01)SCBCBSSC
GP8668MEDICAID (05)SC 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
42D2305441
Facility Type
Physician Office
Certificate Effective Date
May 31, 2026
Certificate Expiration Date
May 30, 2028
Laboratory Director
LOUIS C. PLZAK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Beaufort Memorial Surgical Specialist to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1346474996, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 84. The final step is to find the difference between that total and the next multiple of ten (90 - 84 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
4
Doubled → 8
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
4
Doubled → 8
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 8 + 6 + 8 + 7 + 8 + 9 + 1 + 8 + 24 = 84

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 84 is 90. The difference is the calculated check digit.

90 - 84 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1346474996.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346474996, enumerated as an "organization" on May 12, 2009.

The provider is located at BEAUFORT MEMORIAL SURGICAL SPECIALISTS 989 RIBAUT RD, STE 360 BEAUFORT, SC 29902 and the phone number is (843) 524-8171.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.