NPIMap

Individual provider Active NPI

Timothy James Durkan Gregory, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1073556452
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33129 Issued in SC
Practice address
2060 Charlie Hall Blvd Ste a
Charleston, SC 29414-6066
Phone
(843) 483-0193
Fax
(843) 213-4599
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33129 SC Primary

Addresses

Primary practice location

2060 Charlie Hall Blvd Ste a
Charleston, SC 29414-6066

Mailing address

PO Box R
Pooler, GA 31322-0939
Phone (912) 232-9700

Other practice location 1

105 Burton Ave Ste D
Summerville, SC 29485-8118
Phone (843) 970-5379

Other practice location 2

9304 Medical Plaza Dr Ste A
Charleston, SC 29406-9143
Phone (912) 232-9700 ext. 104

Other identifiers 1

IdentifierTypeStateIssuer
331297MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100916000790 GA Practitioner - Emergency Medicine 1658415336
I20110315000347 SC Practitioner - Emergency Medicine 1658415336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Wound Care LLCGroup PAC ID 4587018437, 3 clinicians

Practice addresses (Care Compare)

2060 Charlie Hall Blvd
Suite a
Charleston, SC 29414-6066
Phone (843) 483-0193

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue723
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33129SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Primary Care Partners, LLC Current Accepting new patients
Hilton Head Emergency Physicians, Inc. Emergency Medicine CurrentSince Jan 24, 2011 Accepting new patients
Coastal Wound Care, LLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Hilton Head Emergency Physicians, LLC Emergency Medicine CurrentSince Jan 24, 2011 Accepting new patients
Trident Medical Center, LLC PastSince Jul 1, 2022 Accepting new patients

Locations

60 Exchange St
Ste B7
Richmond Hill, GA 31324
Phone (912) 756-2273

318 Mall Blvd
Ste 300B
Savannah, GA 31406
Phone (912) 358-1515

2060 Charlie Hall Blvd
Ste A
Charleston, SC 29414
Phone (843) 483-0193

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

5401 Netherby Ln
Ste 301
North Charleston, SC 29420
Phone (843) 483-0193

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1073556452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX R",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313220939",
            "telephone_number": "912-232-9700",
            "fax_number": "839-213-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 CHARLIE HALL BLVD STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146066",
            "telephone_number": "843-483-0193",
            "fax_number": "843-213-4599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Burton Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294858118",
            "country_code": "US",
            "telephone_number": "843-970-5379",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9304 Medical Plaza Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294069143",
            "country_code": "US",
            "telephone_number": "912-232-9700 x104",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES DURKAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "33129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331297",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.