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TIDEWATER KIDNEY SPECIALISTS, INC.
NPI 1780624627
Internal Medicine - Nephrology in Virginia Beach, VA

Active since June 08, 2006
4445 CORPORATION LN STE 100, VIRGINIA BEACH, VA 23462(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 02, 2026.

Record update history: Jan 20, 2022, Feb 13, 2019, Sep 22, 2016 (3 updates tracked since 2016).

About Tidewater Kidney Specialists, Inc. NPPES

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

TIDEWATER KIDNEY SPECIALISTS, INC. (NPI 1780624627) is a healthcare organization registered as a nephrology in Virginia Beach, Virginia and active in the NPI registry since June 2006. The organization lists Elizabeth Skidmore, Administrator, as its authorized official.

NPPES Registry Identity

NPI1780624627
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameTIDEWATER KIDNEY SPECIALISTS, INC.
Location Address4445 CORPORATION LN STE 100Virginia Beach, VA 23462-3666
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 SkidmoreAdministrator · (757) 623-0005
Enumeration DateJune 8, 2006
Last NPPES UpdateJanuary 20, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2022
✔ NPI 1780624627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedSpecialistTaxonomy 174400000X
4445 CORPORATION LN STE 100, Virginia Beach, VA 23462
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Other Identifiers 1

Medicaid890129JNC

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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 1780624627. It was assigned to this organization in the NPPES registry on June 8, 2006.

Where is Tidewater Kidney Specialists, Inc. located?

Tidewater Kidney Specialists, Inc. is located at 4445 Corporation Ln Ste 100, Virginia Beach, VA 23462. 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.

What insurance does Tidewater Kidney Specialists, Inc. accept?

Health plans from Blue Cross and Blue Shield of NC list Tidewater Kidney Specialists, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.