Tidewater Kidney Specialists, Inc.
NPI 1780624627ActiveOrganization· Internal Medicine, Nephrology· Virginia Beach, VA
Internal Medicine, Nephrology in Virginia Beach, Virginia, registered in NPPES in June 2006. The authorized official on file is Elizabeth Skidmore, Administrator. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1780624627 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 8, 2006 |
| Last updated in NPPES | Jan 20, 2022 |
| Certified by provider | Jan 20, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Nephrology Primary | 207RN0300X | — | VA |
| Specialist | 174400000X | — | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (VA) |
|---|
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