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TIDEWATER VASCULAR ACCESS CENTER
NPI 1053678839
Internal Medicine - Nephrology in Norfolk, VA

Active since April 18, 2012CLIA Certified · 6 labs
814 KEMPSVILLE RD, SUITE 101, NORFOLK, VA 23502(757) 623-0005(757) 548-1129 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tidewater Vascular Access Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDEWATER VASCULAR ACCESS CENTER (NPI 1053678839) is a healthcare organization registered as a nephrology in Norfolk, Virginia and active in the NPI registry since April 2012. The organization holds 6 active CLIA laboratory certificates and lists Elizabeth F Skidmore, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1053678839
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameTIDEWATER KIDNEY SPECIALISTS, INC.
Location Address814 KEMPSVILLE RD, SUITE 101Norfolk, VA 23502-4001
Mailing Address4445 Corporation Ln Ste 100Virginia Beach, VA 23462-3666 · (757) 623-0005 · Fax (757) 548-1129
Phone(757) 623-0005
Fax(757) 548-1129
Organization SubpartNo
Authorized OfficialElizabeth F SkidmorePractice Administrator · (757) 623-0005
Enumeration DateApril 18, 2012
Last NPPES UpdateJanuary 20, 2022
NPPES CertifiedJanuary 20, 2022
✔ NPI 1053678839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
814 KEMPSVILLE RD, Norfolk, VA 23502
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Other Names 1

Doing Business AsTidewater Vascular Access Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 6

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0947214

Tidewater Kidney Specialists Inc · Norfolk, VA
Active · expires Sep 20, 2026
CLIA Number49D0947214
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2024
Certificate Expiration DateSeptember 20, 2026
Laboratory DirectorWei David Zhao
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists Inc814 Kempsville Road, Bldg #17 - Suite 102, Norfolk, VA 23502
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D2112354

Tidewater Kidney Specialists, Inc · Suffolk, VA
Active · expires Apr 26, 2028
CLIA Number49D2112354
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2026
Certificate Expiration DateApril 26, 2028
Laboratory DirectorOnweli Ogbolu
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists, Inc3009 Corporate Lane, Suite 210, Suffolk, VA 23434
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0943772

Tidewater Kidney Specialists Inc · Chesapeake, VA
Active · expires Apr 1, 2028
CLIA Number49D0943772
Laboratory TypePhysician Office
Certificate Effective DateApril 2, 2026
Certificate Expiration DateApril 1, 2028
Laboratory DirectorDaniel A. Rakowski
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists Inc300 Medical Parkway, Suite 110, Chesapeake, VA 23320
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D2101100

Tidewater Kidney Specialists, Inc · Virginia Beach, VA
Active · expires Aug 26, 2027
CLIA Number49D2101100
Laboratory TypePhysician Office
Certificate Effective DateAugust 27, 2025
Certificate Expiration DateAugust 26, 2027
Laboratory DirectorMadhu K. Kolli
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists, Inc828 Healthy Way - Suite 270, Virginia Beach, VA 23462
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0947211

Tidewater Kidney Specialists Inc · Norfolk, VA
Active · expires Sep 21, 2026
CLIA Number49D0947211
Laboratory TypePhysician Office
Certificate Effective DateSeptember 22, 2024
Certificate Expiration DateSeptember 21, 2026
Laboratory DirectorYury Kalmanovich
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists Inc500 W 21st Street, Suite 102, Norfolk, VA 23517
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D1010447

Tidewater Kidney Specialists, Inc · Virginia Beach, VA
Active · expires Sep 20, 2026
CLIA Number49D1010447
Laboratory TypePhysician Office
Certificate Effective DateSeptember 21, 2024
Certificate Expiration DateSeptember 20, 2026
Laboratory DirectorHaidr Agha
Laboratory Phone(757) 623-0005
Laboratory LocationTidewater Kidney Specialists, Inc1200 First Colonial Road - Suite 202, Virginia Beach, VA 23454
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN SHANKLIN WEAVER MD
Pain Medicine (Interventional Pain Medicine)
814 KEMPSVILLE RD, SUITE 104
NORFOLK, VA 23502
Norfolk City (757) 455-8887
WEI D. ZHAO M.D.
Internal Medicine (Nephrology)
814 KEMPSVILLE RD, SUITE 102 BLDG 17
NORFOLK, VA 23502
Norfolk City (757) 623-0005
ABDUL W CHAUDHRY M.D.
Internal Medicine (Nephrology)
814 KEMPSVILLE RD, SUITE 102 BLDG 17
NORFOLK, VA 23502
Norfolk City (757) 623-0005
LESLIE OLIVIER
Nurse Practitioner (Family)
814 KEMPSVILLE RD, SUITE 104
NORFOLK, VA 23502
Norfolk City (757) 455-8887

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tidewater Kidney Specialists, Inc.'s NPI number?

The NPI number for Tidewater Kidney Specialists, Inc. is 1053678839. It was assigned to this organization in the NPPES registry on April 18, 2012. The provider is doing business as Tidewater Vascular Access Center.

Where is Tidewater Kidney Specialists, Inc. located?

Tidewater Kidney Specialists, Inc. is located at 814 Kempsville Rd Suite 101, Norfolk, VA 23502. The listed phone number is (757) 623-0005.

What is Tidewater Kidney Specialists, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Tidewater Kidney Specialists, Inc. hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Tidewater Kidney Specialists, Inc. was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.