Individual provider Active NPI

Richard Hagerty, MD

  • Plastic and Reconstructive Surgery Physician
  • Charleston, SC
National Provider Identifier
1790716488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
117796 Issued in SC
Practice address
261 Calhoun St
Suite 200
Charleston, SC 29401-1371
Phone
(843) 722-1985
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 117796 SC Primary

Addresses

Primary practice location

261 Calhoun St
Suite 200
Charleston, SC 29401-1371

Mailing address

261 Calhoun St
Suite 200
Charleston, SC 29401-1371
Phone (843) 722-1985

Other identifiers 1

IdentifierTypeStateIssuer
117796MedicaidSC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
117796SCMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Anesthesia, LLC Past Accepting new patients
Charleston Plastic Surgery Plastic and Reconstructive Surgery PastSince Dec 12, 1996 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790716488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 CALHOUN ST",
            "address_2": "SUITE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011371",
            "telephone_number": "843-722-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CALHOUN ST",
            "address_2": "SUITE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011371",
            "telephone_number": "843-722-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERTY",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "SC",
            "license": "117796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117796",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.