TIDEWATER ANESTHESIA INC (NPI# 1063583722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063583722 |
| Entity Type | Organization |
| Organization Name | TIDEWATER ANESTHESIA INC |
| Practice Address |
1200 First Colonial Rd Virginia Beach VA 23454-2207 |
| Mailing Address |
400 10th St E Waconia MN 55387-4552 |
| Practice Telephone | 8882090305 |
| Practice Fax Number | 9524423620 |
| Mailing Telephone | 8882090305 |
| Mailing Fax Number | 9524423620 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | MARSHA FAISON EDWARDS (PRESIDENT) |
| Authorized Official Telephone | 7574036728 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1200 FIRST COLONIAL RD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053345082 | Eye Surgery Limited LLC | Clinic/Center | 1200 First Colonial Rd, Suite 104, Virginia Beach, VA 23454-2207 | 2006-07-10 |
| 1316343478 | Riverside Hospital, Inc | General Acute Care Hospital | 1200 First Colonial Rd, Suite 204a, Virginia Beach, VA 23454-2207 | 2014-11-17 |
| 1144656133 | Angela Garcia | Nurse Practitioner | 1200 First Colonial Rd, Suite 202, Virginia Beach, VA 23454-2207 | 2013-09-23 |
| 1215242755 | Coastal Plastic Surgery Ltd | Surgery | 1200 First Colonial Rd, Suite 100, Virginia Beach, VA 23454-2274 | 2010-08-09 |
| 1114107729 | Sentara Medical Group | Urology | 1200 First Colonial Rd, Ste 100g, Virginia Beach, VA 23454-2207 | 2007-11-12 |
| 1972799567 | Justin D Martin | Dentist | 1200 First Colonial Rd, Suite #201, Virginia Beach, VA 23454-2207 | 2007-09-18 |
| 1396954715 | Dermatology Inc. of Virginia Beach | Clinic/Center | 1200 First Colonial Rd, Suite 200, Virginia Beach, VA 23454-2207 | 2007-05-22 |
| 1013924588 | George Charles Harr | Dermatology | 1200 First Colonial Rd, Suite 200, Virginia Beach, VA 23454-2207 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700444510 | Brandi Alford | Nurse Anesthetist, Certified Registered | 1110 Arlynn Ln, Virginia Beach, VA 23451-5571 | 2019-06-05 |
| 1275070740 | Anesthesia Care, Inc. | Nurse Anesthetist, Certified Registered | 4148 Gum Bridge Ct, Virginia Beach, VA 23457-1593 | 2017-01-23 |
| 1407033723 | John O. Bennett | Nurse Anesthetist, Certified Registered | 4104 Water Oak Pl, Virginia Beach, VA 23452-2124 | 2008-01-29 |
| 1306857479 | Joanne Frances Smith | Nurse Anesthetist, Certified Registered | 908 Pillow Dr, Virginia Beach, VA 23454-2640 | 2006-08-11 |
| 1639187446 | Jonathan Cotton | Nurse Anesthetist, Certified Registered | 816 Independence Blvd Ste 2g, Virginia Beach, VA 23455-6010 | 2006-08-04 |
| 1700809258 | Carol Jutras Wade | Nurse Anesthetist, Certified Registered | 1975 Glenn Mitchell Dr Ste 300, Virginia Beach, VA 23456-0167 | 2006-07-25 |
| 1104849652 | Elizabeth P. O'connor | Nurse Anesthetist, Certified Registered | 1925 Glenn Mitchell Drive, Suite 102, Gastroenterology Consultants, Virginia Beach, VA 23456 | 2006-07-25 |
| 1740234020 | David Owen Dick | Nurse Anesthetist, Certified Registered | 1504 Cornwell Ln, Virginia Beach, VA 23454-2517 | 2006-05-20 |
| 1033185905 | Anne Dunham Rudolph | Nurse Anesthetist, Certified Registered | 2540 Penshurst Way, Virginia Beach, VA 23456-7811 | 2006-02-28 |
| 1518967538 | Karin Elizabeth Lundgren | Nurse Anesthetist, Certified Registered | 5070 Lauderdale Ave, Virginia Beach, VA 23455-1379 | 2005-08-01 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.