TIDEWATER DOCTORS LLC
NPI 1821769290
Internal Medicine in Charleston, SC

Q: What is Tidewater Doctors LLC's NPI number?

The NPI number for Tidewater Doctors LLC is 1821769290. It was assigned to this organization in the NPPES registry on September 24, 2021.

Q: What is Tidewater Doctors LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since September 24, 2021

2270 ASHLEY CROSSING DR STE 155, CHARLESTON, SC 29414(843) 990-5866(843) 868-8041 Get Directions Write a Review

NPPES record last updated: September 24, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Tidewater Doctors Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDEWATER DOCTORS LLC (NPI 1821769290) is a healthcare organization registered as an internal medicine in Charleston, South Carolina and active in the NPI registry since September 2021. The organization lists Andrea Hurley, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1821769290

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameTIDEWATER DOCTORS LLC

Location Address2270 ASHLEY CROSSING DR STE 155Charleston, SC 29414-5749

Mailing Address2834 Aquaduct StCharleston, SC 29414-7410 · (843) 200-7721

Phone(843) 990-5866

Fax(843) 868-8041

Organization SubpartNo

Authorized OfficialAndrea HurleyPractice Administrator · (843) 200-7721

Enumeration DateSeptember 24, 2021

NPPES CertifiedSeptember 9, 2021

✔ NPI 1821769290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

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.

Also ListedFamily MedicineTaxonomy 207Q00000X

2270 ASHLEY CROSSING DR STE 155, Charleston, SC 29414

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tidewater Doctors Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateSouth CarolinaEnrollment IDO20211109001955Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Tidewater Doctors LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Jeffrey Akhtar, DO

Internal Medicine

NPI 1053370841

2270 ASHLEY CROSSING DR STE 155
Charleston, SC 29414

(843) 225-8308

✔ PECOS✔ Accepts MedicareSame address

Amelia Fairfax, MD

Family Practice

NPI 1629147848

2270 ASHLEY CROSSING DR STE 150
Charleston, SC 29414

(843) 766-1936

✔ PECOS✔ Accepts MedicareSame address

Donald Hurley, D.O.

Family Practice

NPI 1043206410

2270 ASHLEY CROSSING DR STE 150
Charleston, SC 29414

(843) 766-1936

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tidewater Doctors LLC's NPI number?

The NPI number for Tidewater Doctors LLC is 1821769290. It was assigned to this organization in the NPPES registry on September 24, 2021.

Where is Tidewater Doctors LLC located?

Tidewater Doctors LLC is located at 2270 Ashley Crossing Dr Ste 155, Charleston, SC 29414. The listed phone number is (843) 990-5866.

What is Tidewater Doctors LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Tidewater Doctors LLC enrolled in Medicare?

Yes. Tidewater Doctors LLC is registered in the Medicare PECOS enrollment system.

When is Tidewater Doctors LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (South Carolina, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Tidewater Doctors LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Tidewater Doctors LLC, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tidewater Doctors LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care and Ambetter of North Carolina list Tidewater Doctors LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tidewater Doctors LLC was last updated on September 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.