Individual provider Active NPI

Nicholas Q De la Motte Hurst, PA

  • Physician Assistant
  • Gainesville, GA
National Provider Identifier
1831476506
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006327 Issued in GA
Practice address
1498 Jesse Jewell Pkwy SE Ste a
Gainesville, GA 30501-3874
Phone
(678) 257-2547
Fax
(404) 795-5832
NPI assigned
Nov 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 53067 CA
Student in an Organized Health Care Education/Training Program 390200000X GA
Physician Assistant 363A00000X 006327 GA Primary

Addresses

Primary practice location

1498 Jesse Jewell Pkwy SE Ste a
Gainesville, GA 30501-3874

Mailing address

3237 Satellite Blvd Ste 425
Duluth, GA 30096-9009
Phone (678) 257-2547

Other practice location 1

3970 Five Forks Trickum Rd SW Ste A
Lilburn, GA 30047-2339
Phone (678) 257-2547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Orthopaedics LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1831476506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 SATELLITE BLVD STE 425",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300969009",
            "telephone_number": "678-257-2547",
            "fax_number": "404-795-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 JESSE JEWELL PKWY SE STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013874",
            "telephone_number": "678-257-2547",
            "fax_number": "404-795-5832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3970 Five Forks Trickum Rd SW Ste A",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300472339",
            "country_code": "US",
            "telephone_number": "678-257-2547",
            "fax_number": "404-795-5832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA MOTTE HURST",
        "first_name": "NICHOLAS",
        "middle_name": "Q",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-09",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "53067",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.