Jeffrey Eric Hathway, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3961 Issued in SC

Practice address

128 Professional Park Dr
Conway, SC 29526-9260

Phone

(617) 959-4427

NPI assigned

Aug 10, 2006

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Strand Mobile Wound Care

  • Medical Specialty Clinic/Center
  • Myrtle Beach, SC
  • NPI 1508670837
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1982615795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PROFESSIONAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "617-959-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 PROFESSIONAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "617-959-4427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1297 Professional Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775713",
            "country_code": "US",
            "telephone_number": "617-959-4427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATHWAY",
        "first_name": "JEFFREY",
        "middle_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latitia Harvin
• Cynthia Stevens Hasiuk, APRN
• Jack S Haskin Jr., MD
• Susan J Haskin, MD
• Noel C Haskins, MD
• Keri Havron
• David Joel Hawa, ARDMS OB/GYN,ABD,VAS
• Joshua Hayden, DPT
• Hafez M. Hayek, MD
• Angela Denise Hayes-Steadman

• Physician Assistant in Conway, SC
• Providers in Conway, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.