Individual provider Active NPI

Walter McKenzie Hodges, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1598323487
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LL82567 Issued in SC
Practice address
169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone
(843) 792-2300
NPI assigned
Jun 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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 LL82567 SC Primary

Addresses

Primary practice location

169 Ashley Ave RM 202
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave RM 202
Charleston, SC 29425-8905
Phone (843) 792-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220913002709 SC Practitioner - Emergency Medicine 4880925874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (843) 382-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL82567SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
App of South Carolina Ed PLLC Emergency Medicine CurrentSince Oct 29, 2022 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

Organizations & group practices 2

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 1

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1598323487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "WALTER",
        "middle_name": "MCKENZIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL82567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.