NPIMap

Organization Active NPI

Hurst Osteopathic Medicine, a Professional Corp

  • Internal Medicine Physician
  • Tracy, CA
National Provider Identifier
1821394875
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A8081 Issued in CA
Legal business name
HURST OSTEOPATHIC MEDICINE, A PROFESSIONAL CORP
Practice address
1530 Bessie Ave
Suite 104
Tracy, CA 95376-3080
Phone
(209) 833-0272
Fax
(209) 839-8473
NPI assigned
Feb 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Michael D Hurst, D.O.NPI 1205893104
Title
President of Corporation
Phone
(209) 833-0272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 20A8081 CA Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 20A8081 CA

Addresses

Primary practice location

1530 Bessie Ave
Suite 104
Tracy, CA 95376-3080

Mailing address

1530 Bessie Ave
Suite 104
Tracy, CA 95376-3080
Phone (209) 833-0272

Other identifiers 1

IdentifierTypeStateIssuer
00AX80810MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1821394875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 BESSIE AVE",
            "address_2": "SUITE 104",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763080",
            "telephone_number": "209-833-0272",
            "fax_number": "209-839-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BESSIE AVE",
            "address_2": "SUITE 104",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763080",
            "telephone_number": "209-833-0272",
            "fax_number": "209-839-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURST OSTEOPATHIC MEDICINE, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "209-833-0272",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A8081",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A8081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX80810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.