Tidewater Rehabilitation Medicine
LBN: Tidewater Rehabilitation Medicine
Tidewater Rehabilitation Medicine is an health care organization with primary practice located at 1120 First Colonial Rd Suite 206, Virginia Beach VA 23454-2418. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is the primary health care specialty.
Tidewater Rehabilitation Medicine can be contacted via phone (757) 496-2325, or through Kayota, Stephen Walter via phone (757) 496-2325.
Contact Information
Primary practice address
1120 First Colonial Rd Suite 206
Virginia Beach VA 23454-2418
Phone: (757) 496-2325
Fax: (757) 496-1942
Website:
Authorized official contact:
Name: Kayota, Stephen Walter Doctor of Medicine (MD)
Phone: (757) 496-2325
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 0101053621 | Virginia |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 0101053621 | Virginia |
Profile Details
| NPI number | 1891113155 |
|---|---|
| LBN Legal business name | Tidewater Rehabilitation Medicine |
| DBA Doing business as | |
| Authorized official | Kayota, Stephen Walter Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 3rd, 2014 |
| Last updated | Apr 25th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891113155 | NPPES |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | MEDICAID | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
| Virginia | Other | 618120600 | AETNA |
| Virginia | Other | 1891113155 | AETNA |
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