Individual provider Active NPI

Steven Douglas Hurtle Jr., PA-C, PHD

  • Physician Assistant
  • Fort Wainwright, AK
National Provider Identifier
1134438930
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4076 Neely Road, BLDG 4076, Room 1B-201
Fort Wainwright, AK 99703
Phone
(907) 361-5510
NPI assigned
Sep 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4076 Neely Road, BLDG 4076, Room 1B-201
Fort Wainwright, AK 99703

Mailing address

2475 Harney Path
San Antonio, TX 78234-0001
Phone (254) 247-7647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1134438930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 HARNEY PATH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782340001",
            "telephone_number": "254-247-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD, BLDG 4076, ROOM 1B-201",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTLE",
        "first_name": "STEVEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PA-C, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wainwright, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.