TIDEWATER INTEGRATIVE HEALTH PC (NPI# 1710293212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710293212 |
| Entity Type | Organization |
| Organization Name | TIDEWATER INTEGRATIVE HEALTH PC |
| Other Organization Name | SB HUDSON MD PC |
| Practice Address |
802 North Newtown Rd Virginia Beach VA 23462-1116 |
| Practice Telephone | 7574970606 |
| Practice Fax Number | 7574970411 |
| Mailing Telephone | 7574970606 |
| Mailing Fax Number | 7574970411 |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2013-11-19 |
| Authorized Official Name | WALTER KEVIN HUNT (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7574970606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 0101035294 | VA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SB Hudson MD PC | Former Legal Business Name - Organization |
| Street Address |
802 NORTH NEWTOWN RD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-1116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124321120 | Tiffany R Dicenso | Nurse Practitioner | 802 North Newtown Rd, Virginia Beach, VA 23462-1116 | 2010-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912534082 | Cheyenne James | Counselor | 297 Independence Blvd., Virginia Beach, VA 23462 | 2020-03-26 |
| 1245871011 | Marathon Transportation Services LLC | Non-emergency Medical Transport (VAN) | 4505 Main Street, Apt 259, Virginia Beach, VA 23462 | 2019-10-03 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1801387808 | Matrixx Healthcare LLC | Respite Care | 405 S Parliament Dr Ste 106, Virginia Beach, VA 23462 | 2018-05-24 |
| 1518471671 | Newtown Chiropractic Center Pllc | Clinic/Center | 5777 Princess Ann Road, Virginia Beach, VA 23462 | 2017-11-28 |
| 1528587995 | Gary Lee Alexander II | Counselor | 870 N Newtown Road, Virginia Beach, VA 23462 | 2017-09-16 |
| 1801328810 | Servitium Med Va, LLC | Durable Medical Equipment & Medical Supplies | 4445 Corporation Lane Suite 291, Virginia Beach, VA 23462 | 2017-03-29 |
| 1215476171 | Johnnie Walter Cox IIi | Emergency Medical Technician, Basic | 5163 Cleveland Street, Virginia Beach, VA 23462 | 2017-02-13 |
| 1225570179 | Holly Balsamo | Occupational Therapy Assistant | 5345 Marian Lane, Virginia Beach, VA 23462 | 2016-11-09 |
| Find all providers in zip 23462 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629422423 | Paris Ethan Pacheco | Internal Medicine | 1168 First Colonial Rd Ste 200, Virginia Beach, VA 23454-2444 | 2016-04-18 |
| 1477991529 | Leonardo Martin Oliva | Internal Medicine | 1060 First Colonial Rd Fl 1, Virginia Beach, VA 23454-3002 | 2013-06-11 |
| 1982940482 | Hilltop Healthcare LLC | Internal Medicine | 2132 Retreat Ct, Virginia Beach, VA 23454-2256 | 2013-01-02 |
| 1992071096 | Ravinderpal K Gill | Internal Medicine | 2901 S Lynnhaven Rd Ste 450, Virginia Beach, VA 23452 | 2012-03-22 |
| 1881962645 | Bert Wellington Holmes IIi | Internal Medicine | 1253 Nimmo Pkwy, Suite 110, Virginia Beach, VA 23456-7782 | 2011-12-08 |
| 1831483445 | Stella Alice Goings | Internal Medicine | 3908 Lake Front Cir, Suite 201, Virginia Beach, VA 23452-2712 | 2011-06-01 |
| 1063722510 | David S Haden Md PC | Internal Medicine | 5505 Indian River Rd Ste 101, Virginia Beach, VA 23464-5252 | 2010-10-18 |
| 1821316688 | Brian Joseph Lipps | Internal Medicine | 3074 Brickhouse Ct, Virginia Beach, VA 23452-6859 | 2010-05-04 |
| 1851627129 | Amy Marie Goodrich-harris | Internal Medicine | 2008 Winding Lake Ct, Virginia Beach, VA 23456-6305 | 2009-10-21 |
| 1891931622 | Dawn Y Manjoney | Internal Medicine | 308 Susan Constant Dr, Virginia Beach, VA 23451-2146 | 2008-12-29 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
Please comment or provide details below to improve the information on TIDEWATER INTEGRATIVE HEALTH PC.
| 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.