Harrison Dilworth, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101273312 Issued in VA

Practice address

204 W Hill Blvd
Joint Base Charleston, SC 29404-4704

Phone

(843) 963-6800

NPI assigned

Mar 27, 2019

Sex

Male

Sole proprietor

Yes

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1992266548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "JOINT BASE CHARLESTON",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "JOINT BASE CHARLESTON",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILWORTH",
        "first_name": "HARRISON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101273312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tresa Goodwine Barnwell, LISW-CP
• Virginia Bulleman, LISW-CP
• Alysha Buonerba
• Matthew Burns, D.M.D.
• Jazmin Cribb
• Jerry Mark Fletcher, RPH
• David Joseph Fulbrook, DO
• Whitney Mark Galloway, PA-C
• Sara T Hansen, LISW-CP
• Samantha Marie Knapp, PA-C

• Family Medicine Physician in Joint Base Charleston, SC
• Providers in Joint Base Charleston, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.