Organization Active NPI

Durst Family Medicine

  • Family Medicine Physician
  • Sullivans Island, SC
National Provider Identifier
1881754513
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DURST FAMILY MEDICINE
Practice address
306 Station 22 12
Sullivans Island, SC 29482-9768
Phone
(843) 883-3176
Fax
(843) 883-3459
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Wanda Brown
Title
Office Manager
Phone
(843) 883-3176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X SC Primary

Addresses

Primary practice location

306 Station 22 12
Sullivans Island, SC 29482-9768

Mailing address

306 Station 22 1/2
Sullivans Island, SC 29483-9768
Phone (843) 883-3176

Other identifiers 3

IdentifierTypeStateIssuer
1174508378OtherSCNPI
GP3335MedicaidSC
1699750893OtherSCNPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881754513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 STATION 22 1/2",
            "city": "SULLIVANS ISLAND",
            "state": "SC",
            "postal_code": "294839768",
            "telephone_number": "843-883-3176",
            "fax_number": "843-883-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 STATION 22 12",
            "city": "SULLIVANS ISLAND",
            "state": "SC",
            "postal_code": "294829768",
            "telephone_number": "843-883-3176",
            "fax_number": "843-883-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURST FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-883-3176"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174508378",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3335",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699750893",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivans Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.