NPIMap

Organization Active NPI

Liberty Doctors, LLC

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1689051369
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIBERTY DOCTORS, LLC
Practice address
418 Folly Rd Ste a
Charleston, SC 29412-2625
Phone
(843) 795-5362
Fax
(843) 795-1921
NPI assigned
May 1, 2015
Organization subpart
Yes
Parent organization
LIBERTY DOCTORS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Chelsey Dever
Title
Credentialing Coordinator
Phone
(843) 225-8320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X SC Primary

Addresses

Primary practice location

418 Folly Rd Ste a
Charleston, SC 29412-2625

Mailing address

PO Box 13955
Charleston, SC 29422-3955
Phone (843) 225-8304

Other identifiers 1

IdentifierTypeStateIssuer
GP6738MedicaidSC

Other names 1

  • Hugh D. Durrence, MD, PC (Site NPI) Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2096022Liberty Doctors, LLC418 Folly Road, Suite B, Charleston, SC 29412ComplianceSep 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
Liberty Doctors LLC Dba Ebb Tide Comprehensive Care12 organizations share this tax ID, including this one
Part of
Liberty Doctors LLC Dba Ebb Tide Comprehensive Care

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1689051369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13955",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223955",
            "telephone_number": "843-225-8304",
            "fax_number": "843-225-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 FOLLY RD STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122625",
            "telephone_number": "843-795-5362",
            "fax_number": "843-795-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DOCTORS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DOCTORS LLC",
        "enumeration_date": "2015-05-01",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "DEVER",
        "authorized_official_first_name": "CHELSEY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "843-225-8320"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6738",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hugh D. Durrence, MD, PC (Site NPI)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hugh D. Durrence, MD, PC (Site NPI)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.