TIDEWATER RADIATION SERVICES, LLC (NPI# 1801289392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801289392 |
| Entity Type | Organization |
| Organization Name | TIDEWATER RADIATION SERVICES, LLC |
| Practice Address |
1144 N Road St Elizabeth City NC 27909-3473 |
| Mailing Address |
Po Box 31476 Richmond VA 23294-1476 |
| Practice Telephone | 2523844122 |
| Practice Fax Number | 2523844220 |
| Mailing Telephone | 8042668717 |
| Mailing Fax Number | 8042665677 |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | DR. JANETE M MILLS (OWNER) |
| Authorized Official Telephone | 2523844122 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2013-00861 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
1144 N ROAD ST |
| City | ELIZABETH CITY |
| State | NC |
| Zip Code | 27909-3473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639163645 | Pathology Associates II of Eastern North Carolina PC | Pathology | 1144 N Road St, Elizabeth City, NC 27909-3353 | 2005-09-06 |
| 1811597107 | Caroline Poage | Physical Therapist | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2020-10-27 |
| 1639649585 | Hamdi Abdelkader Hamdi Battah | Internal Medicine | 1144 N Road St, Elizabeth City, NC 27909 | 2018-12-03 |
| 1356826705 | Shannon Nicole Hogan | Registered Nurse | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2018-10-02 |
| 1669986857 | Pasquotank River Inpatient Services LLC | Physician Assistant | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2017-11-27 |
| 1093242190 | Courtney Marie Martin | Specialist/Technologist | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2017-05-19 |
| 1093240764 | Rachel Pretko | Emergency Medicine | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2017-05-01 |
| 1710330428 | Old North State Emergency Physicians, LLC | Physician Assistant | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2016-07-18 |
| 1003267006 | Ali Hussain | Internal Medicine | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2016-06-30 |
| 1417308115 | Tartan Emergency Physicians, LLC | Physician Assistant | 1144 N Road St, Elizabeth City, NC 27909-3473 | 2016-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482177 | Leslie Treherne-fayton Dds Pllc | Dentist | 3875 Conlon Way Ste A, Elizabeth City, NC 27909 | 2020-03-13 |
| 1053829077 | Kaitlyn Daniels | Counselor | 1825 West City Drive, Suites A&b, Elizabeth City, NC 27909 | 2018-01-11 |
| 1487183778 | Traniqua Mccullen | Social Worker | 314 Orchard Drive, Elizabeth City, NC 27909 | 2017-06-08 |
| 1760938401 | Lauren Noele Schaefer | Physical Therapist | 615 S Hughes Boulevard, Unit B, Elizabeth City, NC 27909 | 2016-09-01 |
| 1588023279 | Regina Mccoy | Nurse Practitioner | 1507 N Road St Ste 3, Elizabeth City, NC 27909 | 2016-02-23 |
| 1750753760 | Mark C. ''chris'' Patterson | Physician Assistant | Coast Guard Base Elizabeth City, 1664 Weeksville Road, Building 128, Elizabeth City, NC 27909 | 2015-10-29 |
| 1770963365 | Harlan Bradley Hurdle | Pharmacist | 104 Breezewood Drive, Elizabeth City, NC 27909 | 2015-06-09 |
| 1558779298 | Wilkiam Wilson | Counselor | 1290 Halstead Blvd, Elizabeth City, NC 27909 | 2014-07-25 |
| 1871919886 | Courtney Bunch | Specialist/Technologist | 1680 Cedar Point Circle, Elizabeth City, NC 27909 | 2014-03-14 |
| 1790100832 | The Power of U | Community/Behavioral Health | 1023 Us17s Suite 1, Elizabeth City, NC 27909 | 2014-02-26 |
| Find all providers in zip 27909 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639130602 | Janete M Mills | Radiology | 1144a N. Road Street, Elizabeth City, VA 27909 | 2006-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396121745 | Orit Kaidar - Person | Radiology | 101 Manning Drive, Cb #7512, Radiation Oncology, Chapel Hill, NC 27599-7512 | 2015-08-08 |
| 1134547201 | Zachary J Reitman | Radiology | 2301 Erwin Rd Duke University Hospital, Durham, NC 27710 | 2014-04-04 |
| 1861810756 | Susan Gr Mcduff | Radiology | Dumc 20 Duke Medical Center, Durham, NC 27710-0001 | 2014-03-28 |
| 1679830699 | Colette Joan Shen | Radiology | 101 Manning Drive Cb 7512, Chapel Hill, NC 27599-3307 | 2012-04-15 |
| 1124397328 | Aaron Tyler Wild | Radiology | 200 Queens Rd Ste 400, Charlotte, NC 28204-3264 | 2011-12-19 |
| 1891964615 | John William Nelson | Radiology | 5524 Hawthorne Park, Raleigh, NC 27613-6006 | 2008-02-26 |
| 1194905984 | Daniel G. Baseman | Radiology | 70 Neely Rd, Brevard, NC 28712-4267 | 2007-11-08 |
| 1285844183 | John S Moody | Radiology | 501 N. Elam Avenue, Greensboro, NC 27403 | 2007-05-22 |
| 1326251075 | North Carolina Oncology Associates | Radiology | 4101 Macon Pond Road, Raleigh, NC 27607-6319 | 2007-05-08 |
| 1164552865 | Christopher Ryan Kelsey | Radiology | Morris Building, Science Drive, Room 05135, Durham, NC 27710-0001 | 2007-03-06 |
| Find all providers with the same taxonomy | ||||
| City | ELIZABETH CITY |
| Zip Code | 27909 |
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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.