Tidewater Rehabilitation Medicine, NPI 1891113155
Pain Medicine (Physical Medicine & Rehabilitation) Physician in Virginia Beach, VA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1891113155 |
| NPI Entity Type | Organization |
| Provider Name | Tidewater Rehabilitation Medicine |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 1120 First Colonial Rd, Suite 206, Virginia Beach, VA, US |
| Provider Mailing Address | 1120 First Colonial Rd, Suite 206, Virginia Beach, VA, US, 234542418 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | MR. M.D. Stephen Walter Kayota |
| Official Position | SOLE OWNER/AUTHORIZE OFFICIAL |
| Phone | 757-496-2325 |
Group Taxonomy
| Taxonomy Code | 193400000X |
| Taxonomy Name | 193400000X MULTIPLE SINGLE SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, all of who practice with the same area of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Classification | |
| Group | |
| License No. | 0101053621 |
| License State | VA |
| Description | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 0101053621 | VA | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 1891113155 | VA | AETNA | 01 |
| 1891113155 | VA | ANTHEM BCBS VA | 01 |
| 1891113155 | VA | MEDICAID | 05 |
| 1891113155 | VA | OPTIMA | 01 |
| 1891113155 | VA | COVENTRY | 01 |
| 1891113155 | VA | HUMANA MEDICARE | 01 |
| 1891113155 | VA | CIGNA | 01 |
| 1891113155 | VA | VIRGINIA HEALTH NETWORK | 01 |
| 1891113155 | VA | UNITED HEALTHCARE | 01 |
| 618120600 | VA | DEPARTMENT OF LABOR | 01 |
| 1891113155 | VA | TRICARE | 01 |
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