TIDEWATER PHYSICIANS MULTISPECIALTY GROUP (NPI# 1851530851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851530851 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP |
| Other Organization Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP- NEWTOWN MEDICAL, LLC |
| Practice Address |
5424 Discovery Park Blvd Suite 204 Williamsburg VA 23188-2862 |
| Mailing Address |
860 Omni Blvd Ste 101 Newport News VA 23606-4430 |
| Practice Telephone | 7573455870 |
| Practice Fax Number | 7573456927 |
| Mailing Telephone | 7572328769 |
| Mailing Fax Number | 7572328875 |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2019-07-12 |
| Authorized Official Name | ANGELA WALKER (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7572328769 |
| Is Organization Subpart | Y |
| Parent Organization Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Tidewater Physicians Multispecialty Group- Newtown Medical, LLC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598904294 | Tidewater Physicians Multispecialty Group | Durable Medical Equipment & Medical Supplies | 860 Omni Blvd, Suite 203, Newport News, VA 23606-4430 | 2009-02-19 |
| Street Address |
5424 DISCOVERY PARK BLVD SUITE 204 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23188-2862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104813765 | Richard A Parisi | Internal Medicine | 5424 Discovery Park Blvd, 204, Williamsburg, VA 23188 | 2005-09-29 |
| 1881166312 | John Davis Ireland | Physician Assistant | 5424 Discovery Park Blvd, Williamsburg, VA 23188 | 2018-12-21 |
| 1093050692 | Liza M Buckingham | Audiologist | 5424 Discovery Park Blvd, Suite 201, Williamsburg, VA 23188-2904 | 2012-12-07 |
| 1851644165 | Michelle J Clark | Physical Therapist | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2904 | 2012-10-24 |
| 1710255013 | Ellen O Winthrop | Physical Therapist | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2904 | 2011-12-01 |
| 1376838433 | Amanda Mary Jetty | Physical Therapist | 5424 Discovery Park Blvd, Bldg. B /ste. 101, Williamsburg, VA 23188 | 2011-06-16 |
| 1912227471 | Joseph Reza Habibi | Urology | 5424 Discovery Park Blvd, Suite 203, Williamsburg, VA 23188-2904 | 2010-06-08 |
| 1356501068 | Matthew T. Doherty | Radiology | 5424 Discovery Park Blvd, Williamsburg, VA 23188 | 2008-06-16 |
| 1740451251 | Thomas Durbin | Orthopaedic Surgery | 5424 Discovery Park Blvd, Suite 204, Williamsburg, VA 23188-2904 | 2008-03-13 |
| 1376765032 | Kerry Bate | Specialist | 5424 Discovery Park Blvd, Bldg. B Ste. 101, Williamsburg, VA 23188 | 2007-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
| 1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
| 1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
| 1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
| 1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
| 1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
| 1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
| 1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
| 1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
| 1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
| Find all providers in zip 23188 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226801 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1651 Merrimac Trl Ste 159, Williamsburg, VA 23185-5624 | 2018-05-21 |
| 1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
| 1245679232 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4670 Casey Blvd, Williamsburg, VA 23188-2879 | 2013-06-23 |
| 1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
| 1265693519 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 200 Marquis Pkwy, Williamsburg, VA 23185-5371 | 2008-06-19 |
| 1316113764 | Dr Jean M Clay, PC | Durable Medical Equipment & Medical Supplies | 302 Bulifants Blvd Ste 101, Williamsburg, VA 23188-5738 | 2008-05-06 |
| 1407974009 | Sentara Medical Group | Durable Medical Equipment & Medical Supplies | 2000 Easter Cir, Williamsburg, VA 23188-1416 | 2007-03-26 |
| 1003931635 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 1309 Richmond Rd, Williamsburg, VA 23185-2832 | 2007-03-20 |
| 1427113661 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 4501 News Road, Williamsburg, VA 23188 | 2006-12-27 |
| 1548335797 | Sentara Enterprises | Durable Medical Equipment & Medical Supplies | 6623 Richmond Rd, Suite J, Williamsburg, VA 23188-7589 | 2006-11-22 |
| Find all providers in WILLIAMSBURG | ||||
| City | WILLIAMSBURG |
| Zip Code | 23188 |
Please comment or provide details below to improve the information on TIDEWATER PHYSICIANS MULTISPECIALTY GROUP.
| 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.