TIDEWATER DIAGNOSTIC IMAGING LTD (NPI# 1073626396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073626396 |
| Entity Type | Organization |
| Organization Name | TIDEWATER DIAGNOSTIC IMAGING LTD |
| Practice Address |
3000 Coliseum Dr Sentara Careplex Hospital Hampton VA 23666 |
| Mailing Address |
Po Box 12127 Newport News VA 23612-2127 |
| Practice Telephone | 7577361621 |
| Practice Fax Number | 7578276748 |
| Mailing Telephone | 7578676101 |
| Mailing Fax Number | 7578676587 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-01-11 |
| NPI Deactivation Date | 01/08/2019 |
| NPI Reactivation Date | 2019-01-11 |
| Authorized Official Name | WILLIAM WALLACE RITCHIE (PRESIDENT) |
| Authorized Official Telephone | 7577363217 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 265930 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Tidewater Diagnostic Imaging Ltd. | Po Box 12127, Newport News, Virginia 23612-2127 |
| Street Address |
3000 COLISEUM DR SENTARA CAREPLEX HOSPITAL |
| City | HAMPTON |
| State | VA |
| Zip Code | 23666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457355075 | Ilham Cherrouk Grant | Hospitalist | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2005-06-10 |
| 1639783798 | Aftab Dee Shaikh | Physician Assistant | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2020-09-04 |
| 1205462496 | Lindsay Morgan Wilson | Nurse Practitioner | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2020-03-19 |
| 1346898715 | Megan Leanne Mancinelli | Physician Assistant | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2019-08-29 |
| 1811541519 | Hope Christopher Page | Nurse Practitioner | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2019-07-31 |
| 1417417213 | Katherine Marie Boucher | Nurse Practitioner | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2019-03-20 |
| 1861958712 | Emily Dickerson | Nurse Practitioner | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2019-02-15 |
| 1013481829 | Mary Townsend Adams | Nurse Practitioner | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2019-01-15 |
| 1801327457 | Rachel Lavender | Physician Assistant | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2017-03-24 |
| 1629427588 | Mary Kathryn Winters | Physician Assistant | 3000 Coliseum Dr, Hampton, VA 23666-5963 | 2016-06-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548824022 | Melanin Excellence Medical Transportation Co LLC | Non-emergency Medical Transport (VAN) | 4418 East Claiborne Sq, Suite 334, Hampton, VA 23666 | 2019-04-30 |
| 1952880502 | Exquisite Counseling Services LLC | Counselor | 2703 Build America Drive, Hampton, VA 23666 | 2018-08-13 |
| 1063999811 | Speak From The Heart | Speech-Language Pathologist | 2 Abbott Dr, Hampton, VA 23666 | 2018-07-24 |
| 1245724632 | Drashti Khamar | Dentist | 2040 Coliseum Dr # A27, Hampton, VA 23666 | 2018-06-19 |
| 1750874772 | Dion J Roszina | Private Vehicle | 806 Charlton,dr, Hampton, VA 23666 | 2018-06-13 |
| 1205352481 | Crystal Lynn Harris | Counselor | 2021 Cunningham Drive, Suite 400, Hampton, VA 23666 | 2017-08-18 |
| 1538693361 | Marquis A. Norton | Counselor | 4410 East Claiborne Street, Suite 334, Hampton, VA 23666 | 2017-04-18 |
| 1194181966 | Key Elements Care, LLC | Case Management | 20 Research Dr Ste 600, Hampton, VA 23666 | 2016-01-11 |
| 1740665215 | Lauren-grey Gonzales Igel | Hearing Instrument Specialist | 1507 Hardy Cash Drive, Hampton, VA 23666 | 2015-07-27 |
| 1457758062 | Alexandra Levine | Acupuncturist | 2216 Executive Dr Ste A, Hampton, VA 23666 | 2014-11-25 |
| Find all providers in zip 23666 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316111552 | Yale Richmond | Radiology | 418 Rick Rd, Hampton, NJ 08827-4302 | 2008-04-18 |
| 1225215155 | Douglas Carl Vander Kooi | Radiology | 33 Nealy Blvd, Dept of Radiology, Hampton, VA 23665-2023 | 2008-01-22 |
| 1043322738 | Steven M Hall | Radiology | Sentava Careplex Hospital, 3000 Coliseum Dr, Hampton, VA 23666 | 2006-08-31 |
| 1801862701 | Steven Todd Pietruszynski | Radiology | 3000 Coliseum Dr., Sentara Caveplex Hospital, Hampton, VA 23666-5963 | 2006-02-28 |
| 1114012762 | Mozhdeh Salour | Radiology | 3000 Coliseum Dr, Sentara Caveplex Hospital, Hampton, VA 23666 | 2006-10-03 |
| 1871608190 | Kishore Gadahad Rao | Radiology | 3000 Coliseum Dr, Sentara Careplex Hospital, Hampton, VA 23666-5963 | 2006-08-19 |
| 1164535480 | William Wallace Ritchie | Radiology | 3000 Coliseum Dr, Sentara Careplex Hospital, Hampton, VA 23666 | 2006-08-17 |
| 1174636377 | Kevin Keith Woisard | Radiology | 3000 Coliseum Dr, Sentara Careplex Hospital, Hampton, VA 23666 | 2006-08-15 |
| 1811900251 | Stephen A Fink | Radiology | 3000 Coliseum Dr, Sentara Careplex Hospital, Hampton, VA 23666 | 2006-08-15 |
| 1316958648 | Bennie Alan Skinner | Radiology | 3000 Coliseum Dr, Sentara Careplex Hospital, Hampton, VA 23666 | 2006-08-11 |
| Find all providers in HAMPTON | ||||
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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.