NPIMap

Individual provider Active NPI

Donald P Hurley, D.O.

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1043206410
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SC0310 Issued in SC
Practice address
2270 Ashley Crossing Dr Ste 150
Charleston, SC 29414-5702
Phone
(843) 766-1936
Fax
(843) 766-1206
NPI assigned
Sep 21, 2005
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SC0310 SC Primary

Addresses

Primary practice location

2270 Ashley Crossing Dr Ste 150
Charleston, SC 29414-5702

Mailing address

2834 Aquaduct St
Charleston, SC 29414-7410
Phone (843) 766-1936

Other identifiers 3

IdentifierTypeStateIssuer
GP3558MedicaidSC
3105MedicaidSC
043611743OtherSCFEDERAL ID NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000255 SC Practitioner - Family Practice 6901811009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Doctors LLCGroup PAC ID 2466841655, 3 clinicians

Practice addresses (Care Compare)

2270 Ashley Crossing Dr
Suite 150
Charleston, SC 29414-5702
Phone (843) 766-1936

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Doctors LLC Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Tidewater Doctors LLC Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Tidewater Doctors LLC Family Medicine Past Accepting new patients

Locations

2270 Ashley Crossing Dr
Ste 150
Charleston, SC 29414
Phone (843) 766-1936

Interoperability endpoints

  • Direct secure messaging: dhurley@tide.ssdirect.aprima.com

Organizations & group practices 3

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 8

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1043206410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 AQUADUCT ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147410",
            "telephone_number": "843-766-1936",
            "fax_number": "843-766-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 ASHLEY CROSSING DR STE 150",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145702",
            "telephone_number": "843-766-1936",
            "fax_number": "843-766-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "DONALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "SC0310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3558",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3105",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL ID NUMBER",
            "identifier": "043611743",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.