Tides Gastroenterology, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

TIDES GASTROENTEROLOGY, LLC

Practice address

159 E Shipyard Rd
Mt Pleasant, SC 29464-2677

Phone

(843) 743-4241

NPI assigned

Jul 21, 2014

Last updated

Jul 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Dorociak

Title

President

Phone

(843) 743-4241

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9560/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1437566510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 E SHIPYARD RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294642677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E SHIPYARD RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294642677",
            "telephone_number": "843-743-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDES GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "DOROCIAK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-743-4241",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jane Thurber, RD
• Seaborn Michael Thurman, DMD
• Lara Jennifer Tiberian
• Sara Sharnoff Tick, LMFT
• Tidal Creek Dental LLC
• Tides of Change Counseling, LLC
• Tidewater Health PC (Tidewater Health)
• Tidewater Neurology
• Tidewater Pharmacy & Medical Supply LLC (Tidewater Pharmacy & Compounding)
• Tidewater Pharmacy & Medical Supply LLC (Tidewater Pharmacy & Compounding)

• Gastroenterology Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Gastroenterology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.