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TIDEWATER ALLERGY AND ASTHMA LLC
NPI 1629889308
Allergy & Immunology in Virginia Beach, VA

Active since January 14, 2025
4534 BONNEY RD STE B, VIRGINIA BEACH, VA 23462(757) 499-4101(757) 497-2419 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tidewater Allergy And Asthma Llc NPPES

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

TIDEWATER ALLERGY AND ASTHMA LLC (NPI 1629889308), doing business as Tidewater Allery And Asthma, is a healthcare organization registered as an allergy & immunology in Virginia Beach, Virginia and active in the NPI registry since January 2025. The organization maintains a secondary practice location in Chesapeake and lists Jeremy Ray Owens, Owner, as its authorized official.

NPPES Registry Identity

NPI1629889308
Entity TypeOrganization
Primary Taxonomy207K00000X
Legal Business NameTIDEWATER ALLERGY AND ASTHMA LLC
Location Address4534 BONNEY RD STE BVirginia Beach, VA 23462-3873
Mailing Address1828 Duke Of Norfolk QuayVirginia Beach, VA 23454-1106
Phone(757) 499-4101
Fax(757) 497-2419
Organization SubpartNo
Authorized OfficialJeremy Ray OwensOwner · (757) 572-6052
Enumeration DateJanuary 14, 2025
Last NPPES UpdateApril 3, 2025
NPPES CertifiedApril 3, 2025
✔ NPI 1629889308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
4534 BONNEY RD STE B, Virginia Beach, VA 23462
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Other Names 1

Doing Business AsTidewater Allery And Asthma

Secondary Practice Location 1

Location 1516 Innovation Dr Ste 306Chesapeake, VA 23320-3866 · Phone (757) 499-4101

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tidewater Allergy And Asthma Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Tidewater Allergy And Asthma LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jeremy Owens, MD
Allergy/Immunology
NPI 1740743053
4534 BONNEY RD STE B
Virginia Beach, VA 23462
(757) 499-4101
✔ PECOS✔ Accepts MedicareSame address
Christina Barnett, FNP
Nurse Practitioner
NPI 1710508049
4534 BONNEY RD STE B
Virginia Beach, VA 23462
(757) 499-4101
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Allergy And Asthma LLC's NPI number?

The NPI number for Tidewater Allergy And Asthma LLC is 1629889308. It was assigned to this organization in the NPPES registry on January 14, 2025. The provider is doing business as Tidewater Allery and Asthma.

Where is Tidewater Allergy And Asthma LLC located?

Tidewater Allergy And Asthma LLC is located at 4534 Bonney Rd Ste B, Virginia Beach, VA 23462. The listed phone number is (757) 499-4101.

What is Tidewater Allergy And Asthma LLC's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Is Tidewater Allergy And Asthma LLC enrolled in Medicare?

Yes. Tidewater Allergy And Asthma LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidewater Allergy And Asthma LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Tidewater Allergy And Asthma LLC, in Allergy/Immunology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tidewater Allergy And Asthma LLC was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.