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CAMELOT DIALYSIS
NPI 1710066428
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Virginia Beach, VA

Active since November 03, 2006CLIA 49D0228897 · Waiver
1800 CAMELOT DR, STE 100, VIRGINIA BEACH, VA 23454(757) 481-6879(757) 496-0187 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Camelot Dialysis NPPES

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

CAMELOT DIALYSIS (NPI 1710066428) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Virginia Beach, Virginia and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Thomas O Usilton, Sr Vice President, as its authorized official.

NPPES Registry Identity

NPI1710066428
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDAVITA TIDEWATER - VIRGINIA BEACH, LLC
Location Address1800 CAMELOT DR, STE 100Virginia Beach, VA 23454-2440
Mailing Address5200 Virginia Way, Ste 400 L&cBrentwood, TN 37027-7569 · (615) 320-4218 · Fax (303) 209-7825
Phone(757) 481-6879
Fax(757) 496-0187
Organization SubpartNo
Authorized OfficialThomas O UsiltonSr Vice President · (770) 541-7922
Enumeration DateNovember 3, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1710066428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
1800 CAMELOT DR, Virginia Beach, VA 23454
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Other Names 1

Doing Business AsCamelot Dialysis

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 49D0228897

Camelot Dialysis Center · Virginia Beach, VA
Active · expires Aug 31, 2026
CLIA Number49D0228897
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMadhu Holli
Laboratory Phone(804) 481-6879
Laboratory LocationCamelot Dialysis Center1800 Camelot Drive - Suite 100, Virginia Beach, VA 23454
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MS. ANDREA MARIE MACKIE OT
Occupational Therapist (Hand)
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-4284
MR. ANDREW B COULTER PT
Physical Therapist
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-3300
ANDREA SCHOTT PT
Physical Therapist
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-3300
VANN VIRGINIA CENTER FOR ORTHOPAEDICS
Physical Therapist
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-4284
SENTARA MEDICAL GROUP
Pediatrics
1800 CAMELOT DR, STE 200
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 252-9600
TIMOTHY BUDORICK MD
Orthopaedic Surgery
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-3300
CYNTHIA COOPER OT
Occupational Therapist
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-3300
MS. CHRISTINA GRACE MCCARVILLE DPT
Physical Therapist
1800 CAMELOT DR, SUITE 300
VIRGINIA BEACH, VA 23454
Virginia Beach City (757) 321-4284

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 Davita Tidewater - Virginia Beach, LLC's NPI number?

The NPI number for Davita Tidewater - Virginia Beach, LLC is 1710066428. It was assigned to this organization in the NPPES registry on November 3, 2006. The provider is doing business as Camelot Dialysis.

Where is Davita Tidewater - Virginia Beach, LLC located?

Davita Tidewater - Virginia Beach, LLC is located at 1800 Camelot Dr Ste 100, Virginia Beach, VA 23454. The listed phone number is (757) 481-6879.

What is Davita Tidewater - Virginia Beach, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Davita Tidewater - Virginia Beach, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0228897) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Davita Tidewater - Virginia Beach, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.