TIDEWATER DOCTORS LLC
NPI 1821769290
Internal Medicine in Charleston, SC

NPI Status: Active since September 24, 2021

Contact Information

2270 ASHLEY CROSSING DR STE 155
CHARLESTON, SC
ZIP 29414
Phone: (843) 990-5866
Fax: (843) 868-8041

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  • Organization
  • Internal Medicine
  • Accepts Insurance
  • CLIA Number: 42D2145618
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-12-2026

About TIDEWATER DOCTORS LLC

This page provides the complete NPI Profile along with additional information for Tidewater Doctors Llc, an internist established in Charleston, South Carolina operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1821769290 assigned on September 2021. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Tidewater Doctors Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Andrea Hurley (Practice Administrator)

NPI
1821769290
Provider Name
TIDEWATER DOCTORS LLC
Entity Type
Organization
Location Address
2270 ASHLEY CROSSING DR STE 155 CHARLESTON, SC 29414
Location Phone
(843) 990-5866
Location Fax
(843) 868-8041
Mailing Address
2834 AQUADUCT ST CHARLESTON, SC 29414
Mailing Phone
(843) 200-7721
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-24-2021
Last Update Date
09-24-2021
Code Navigator

An internist like Tidewater Doctors Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANDREA HURLEY

Authorized Official Title
PRACTICE ADMINISTRATOR
Authorized Official Phone
(843) 200-7721

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
42D2145618
Facility Type
Physician Office
Certificate Effective Date
March 13, 2024
Certificate Expiration Date
March 12, 2026
Laboratory Director
JEFFREY M. AKHTAR
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Tidewater Doctors Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for TIDEWATER DOCTORS LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1821769290, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
2
Doubled → 4
Pos 4
1
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 7 → 14 → 5 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 4 + 1 + 1 + 4 + 6 + 1 + 8 + 2 + 1 + 8 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1821769290.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Internal Medicine
2270 ASHLEY CROSSING DR STE 155
CHARLESTON, SC 29414

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821769290, enumerated as an "organization" on September 24, 2021.

The provider is located at 2270 ASHLEY CROSSING DR STE 155 CHARLESTON, SC 29414 and the phone number is (843) 990-5866.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care and Ambetter of. Please consult your insurance carrier or call the provider to verify.