TIDEWATER PEDIATRICS, P.C. (NPI# 1134685050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134685050 |
Entity Type | Organization |
Organization Name | TIDEWATER PEDIATRICS, P.C. |
Practice Address |
301 Goode Way Ste 203 Portsmouth VA 23704-2266 |
Practice Telephone | 7573995300 |
Mailing Telephone | 7573995300 |
Mailing Fax Number | 7573995987 |
Enumeration Date | 2019-02-15 |
Last Update Date | 2019-02-15 |
Authorized Official Name | DR. LAARNI SERQUINA BIBAY (PRESIDENT) |
Authorized Official Telephone | 7573995300 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | 1841206166 | 05 |
Street Address |
301 GOODE WAY STE 203 |
City | PORTSMOUTH |
State | VA |
Zip Code | 23704-2266 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457973588 | Ralpheana Denee Lawton | Clinic/Center | 2317 Richmond Ave, Portsmouth, VA 23704 | 2020-05-12 |
1376079186 | Faithful Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1509 Parker Ave, Portsmouth, VA 23704 | 2017-05-11 |
1285184168 | Sarah Crawford | Counselor | Harbor Point, 301 Fort Lane, Portsmouth, VA 23704 | 2016-10-04 |
1295137560 | Sarah Lee Arnell Rogers | Registered Nurse | 935 Blair Steet, Portsmouth, VA 23704 | 2014-09-18 |
1396161212 | Cheryl Denise Mcneil | Home Health | 1416 Portsmouth Boulevard, Portsmouth, VA 23704 | 2014-03-17 |
1609173988 | Roberta Marie Hansel-union | Behavioral Analyst | 711 Court Street, Portsmouth, VA 23704 | 2011-02-22 |
1447560875 | Denise Anderson Anderson | Licensed Vocational Nurse | 1227 Summit Ave, Portsmouth, VA 23704 | 2010-10-19 |
1770890204 | Reymond G. Pascual Md.,pc | Specialist | 704 London Blvd, Portsmouth, VA 23704 | 2010-09-03 |
1184820003 | Charles Seth Eisenberg | Internal Medicine | Nmcp Cardiology, 620 John Paul Jones Cir, Portsmouth, VA 23704 | 2007-06-26 |
1902028251 | James Bentley Treatment Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1020 Leckie Street, Portsmouth, VA 23704 | 2007-05-03 |
Find all providers in zip 23704 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164683967 | Kathlyn Valleau Wilde | Pediatrics | 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111 | 2008-06-24 |
1437235421 | Perla Jamias Soloria | Pediatrics | 3701 South St, Portsmouth, VA 23707-3121 | 2006-10-31 |
1265523310 | Portsmouth Pediatrics | Pediatrics | 1985 E Main Rd, Portsmouth, RI 02871-1225 | 2006-09-27 |
1508884503 | John R Radford | Pediatrics | 1611 27th St Ste 101, Portsmouth, OH 45662-6932 | 2006-07-17 |
1679529424 | Kevin Hodges | Pediatrics | 200 Griffin Rd, Suite 15, Portsmouth, NH 03801-7145 | 2006-05-25 |
1225089196 | Rick David Murphy | Pediatrics | 1405 11th St, Portsmouth, OH 45662 | 2006-05-15 |
1811956204 | 04gloria Villanueva De La Cruz | Pediatrics | 500 Rodman Ave, Portsmouth, VA 23707-3100 | 2006-03-22 |
1205800489 | Lilliam I. Ortiz | Pediatrics | 23030 State Route 73, Portsmouth, OH 45663-8861 | 2006-02-15 |
1528039328 | Caleb John Podraza | Pediatrics | Naval Medical Center Department of Pediatrics, 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2006-01-30 |
1437129202 | Olivia Y Alegre - Ipanag | Pediatrics | 446 Effingham St., Ste 302, Portsmouth, VA 23704-4818 | 2006-01-25 |
Find all providers in PORTSMOUTH |
City | PORTSMOUTH |
Zip Code | 23704 |
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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.