TIDEWATER PEDIATRICS, P.C.


Address: 301 Goode Way Ste 203, Portsmouth, VA 23704-2266
Phone: 7573995300

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA 1841206166 05

Office Location

Street Address 301 GOODE WAY STE 203
City PORTSMOUTH
State VA
Zip Code 23704-2266

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City PORTSMOUTH
Zip Code 23704

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Dataset Information

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.

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