TIDEWATER FAMILY PRACTICE, P.C.
NPI 1750462628
Family Medicine in Virginia Beach, VA
About Tidewater Family Practice, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIDEWATER FAMILY PRACTICE, P.C. (NPI 1750462628) is a healthcare organization registered as a family medicine in Virginia Beach, Virginia and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through August 15, 2028 and lists David Brannon Holt, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Family Practice, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Tidewater Family Practice, P.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Compliance 49D0228956
Tidewater Family Practice PC · Virginia Beach, VAFrequently 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 Family Practice, P.C.'s NPI number?
The NPI number for Tidewater Family Practice, P.C. is 1750462628. It was assigned to this organization in the NPPES registry on October 18, 2006.
Where is Tidewater Family Practice, P.C. located?
Tidewater Family Practice, P.C. is located at 4660 Haygood Rd, Virginia Beach, VA 23455. The listed phone number is (757) 460-0243.
What is Tidewater Family Practice, P.C.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Tidewater Family Practice, P.C. enrolled in Medicare?
Yes. Tidewater Family Practice, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tidewater Family Practice, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Tidewater Family Practice, P.C.. 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. The largest specialties are Nurse Practitioner (3) and Family Practice (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Tidewater Family Practice, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 49D0228956) is associated with this NPI, valid through August 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Tidewater Family Practice, P.C. 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 6 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.
# Tidewater Family Practice, P.c. · NPI 1750462628
Family Medicine organization in Virginia Beach, Virginia. Organization record, active in the CMS NPPES registry since October 18, 2006.
## Identity
- **NPI:** 1750462628 (Entity type: Organization)
- **Enumerated:** October 18, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** David Holt, OWNER
## Practice location
- **Address:** 4660 HAYGOOD RD, Virginia Beach, VA 23455-5436
- **Phone:** (757) 460-0243 · **Fax:** (757) 460-1011
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (1); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1750462628) · Data from the CMS NPPES public registry.