TIDEWATER LACTATION GROUP, INC. (NPI# 1790999621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790999621 |
| Entity Type | Organization |
| Organization Name | TIDEWATER LACTATION GROUP, INC. |
| Practice Address |
205 Business Park Dr Suite 104 Virginia Beach VA 23462-6535 |
| Mailing Address |
928 Sydenham Blvd Chesapeake VA 23322-6819 |
| Practice Telephone | 7576424568 |
| Practice Fax Number | 7574558055 |
| Mailing Telephone | 7576424568 |
| Mailing Fax Number | 7574558055 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-11-28 |
| Authorized Official Name | MS. ELIZABETH IRELAND FLIGHT (PRESIDENT) |
| Authorized Official Telephone | 7576186311 |
| Authorized Official Credential | BSN, RN, IBCLC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
0001182636 | VA | Nursing Service Providers |
| Street Address |
205 BUSINESS PARK DR SUITE 104 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-6535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821024597 | Cardiology Consultants, Ltd | Internal Medicine | 205 Business Park Dr, Suite 200, Virginia Beach, VA 23462-6535 | 2006-06-24 |
| 1043653546 | Renee Shantel Jones | Registered Nurse | 205 Business Park Dr, Suite 104, Virginia Beach, VA 23462-6535 | 2013-04-15 |
| 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 | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467011510 | Amy Taylor | Registered Nurse | 4176 S Plaza Trl Ste 217, Virginia Beach, VA 23452-1920 | 2019-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720687874 | Leah M Tribus | Registered Nurse | 1236 Windswept Cir, Chesapeake, VA 23320-5010 | 2020-10-20 |
| 1417562505 | Belma Skaljic | Registered Nurse | 8370 Greensboro Dr Unit 314, Mc Lean, VA 22102-3516 | 2020-09-15 |
| 1669085585 | Jennifer Clare Defranco | Registered Nurse | 4475 Corral Rd, Warrenton, VA 20187-5820 | 2020-08-29 |
| 1972126142 | Amy Fay Alliston | Registered Nurse | 308b S Main St Ste 221, Farmville, VA 23901-1744 | 2020-05-22 |
| 1770114068 | Heather Smith | Registered Nurse | 1398 New Hope Rd, Staunton, VA 24401-9262 | 2020-01-27 |
| 1740829506 | Kendra Danielle Carroll | Registered Nurse | 3424 Ashmeade Dr, Roanoke, VA 24018-3702 | 2019-12-27 |
| 1245882802 | Brenda Lee Knighton | Registered Nurse | 12928 Crews Ct, Bristow, VA 20136-3112 | 2019-07-14 |
| 1679036883 | Alison Grace Stamper Levy | Registered Nurse | 2001 N Upton St, Arlington, VA 22207-2326 | 2019-04-14 |
| 1518426816 | Emily Bender | Registered Nurse | 4781 Back Mountain Rd, Winchester, VA 22602-3462 | 2019-03-16 |
| 1184189888 | Cynthia Bauley | Registered Nurse | 7829 Glenister Dr, Springfield, VA 22152-2007 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
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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.