NPIMap

Individual provider Active NPI

Douglas A Stahura, D.O.

  • Nephrology Physician
  • Aiken, SC
National Provider Identifier
1467416487
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
721 Issued in SC
Practice address
755 Medical Park Dr
Aiken, SC 29801-6306
Phone
(803) 648-0718
Fax
(803) 641-9143
NPI assigned
Apr 14, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 721 SC Primary

Addresses

Primary practice location

755 Medical Park Dr
Aiken, SC 29801-6306

Mailing address

755 Medical Park Dr
Aiken, SC 29801-6306
Phone (803) 648-0718

Other identifiers 2

IdentifierTypeStateIssuer
7522575OtherSCAETNA PROVIDER NUMBER
007218MedicaidSC

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
I20040421000009 SC Practitioner - Nephrology 3971599655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ohio University, College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Csra Renal Services, LLCGroup PAC ID 1254323660, 4 clinicians

Practice addresses (Care Compare)

755 Medical Park Dr
Aiken, SC 29801-6306
Phone (803) 648-0718

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
721SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Csra Renal Services, LLC Nephrology CurrentSince Aug 1, 2003 Accepting new patients

Locations

755 Medical Park Dr
Aiken, SC 29801
Phone (803) 648-0718

10708 Marlboro Ave
Barnwell, SC 29812
Phone (803) 541-7225

Interoperability endpoints

  • Direct secure messaging: douglas.stahura.1@27530.direct.athenahealth.com

Organizations & group practices 1

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 10

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467416487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEDICAL PARK DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016306",
            "telephone_number": "803-648-0718",
            "fax_number": "803-641-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEDICAL PARK DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016306",
            "telephone_number": "803-648-0718",
            "fax_number": "803-641-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHURA",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7522575",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007218",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.