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FAMILY PHYSICIANS OF TIDEWATER PLLC
NPI 1790830826
Family Medicine in Norfolk, VA

Active since January 25, 2007CLIA 49D0685010 · Waiver
110 KINGSLEY LN, SUITE 202, NORFOLK, VA 23505(757) 889-6520(757) 489-4905 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Family Physicians Of Tidewater Pllc NPPES

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

FAMILY PHYSICIANS OF TIDEWATER PLLC (NPI 1790830826) is a healthcare organization registered as a family medicine in Norfolk, Virginia and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through March 17, 2028 and lists Clement Stokes Kirkland, President, as its authorized official.

NPPES Registry Identity

NPI1790830826
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY PHYSICIANS OF TIDEWATER PLLC
Location Address110 KINGSLEY LN, SUITE 202Norfolk, VA 23505-4614
Mailing Address110 Kingsley Ln, Suite 202Norfolk, VA 23505-4614 · (757) 889-6520 · Fax (757) 489-4905
Phone(757) 889-6520
Fax(757) 489-4905
Organization SubpartNo
Authorized OfficialClement Stokes KirklandPresident · (757) 889-6520
Enumeration DateJanuary 25, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1790830826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
110 KINGSLEY LN, Norfolk, VA 23505
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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

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 49D0685010

Family Physicians Of Tidewater, PC · Norfolk, VA
Active · expires Mar 17, 2028
CLIA Number49D0685010
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorDavid S. Kirkland
Laboratory Phone(757) 622-6520
Laboratory LocationFamily Physicians Of Tidewater, PC425 West 20th Street - Suite 1, Norfolk, VA 23517
CLIA data matches this NPI record on: 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.

MARYVIEW HOSPITAL
Counselor
110 KINGSLEY LN, STE 206
NORFOLK, VA 23505
Norfolk City (757) 398-2374
DR. KEVIN HALISTA M.D.
Radiology (Diagnostic Radiology)
110 KINGSLEY LN, SUITE 305
NORFOLK, VA 23505
Norfolk City (804) 262-6900
ANTOINE A ARRAGE MD
Internal Medicine
110 KINGSLEY LN, SUITE 106
NORFOLK, VA 23505
Norfolk City (757) 889-5735
LAURA RIDDLE AGACNP-BC
Nurse Practitioner (Acute Care)
110 KINGSLEY LN, SUITE 411
NORFOLK, VA 23505
Norfolk City (757) 889-5040
E HAQUE LLC
Internal Medicine
110 KINGSLEY LN, SUITE 209
NORFOLK, VA 23505
Norfolk City (757) 489-3911
ANNAMALAI MUTHIAH JR. MD
Radiology (Diagnostic Radiology)
110 KINGSLEY LN, 305
NORFOLK, VA 23505
Norfolk City (757) 889-5422
MARLENE B LORENZ NP
Nurse Practitioner
110 KINGSLEY LN, SUITE 312
NORFOLK, VA 23505
Norfolk City (757) 354-2885
TIDEWATER SPEECH AND LANGUAGE SERVICES
Speech-Language Pathologist
110 KINGSLEY LN, SUITE 209
NORFOLK, VA 23505
Norfolk City (757) 423-1933

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 Family Physicians Of Tidewater PLLC's NPI number?

The NPI number for Family Physicians Of Tidewater PLLC is 1790830826. It was assigned to this organization in the NPPES registry on January 25, 2007.

Where is Family Physicians Of Tidewater PLLC located?

Family Physicians Of Tidewater PLLC is located at 110 Kingsley Ln Suite 202, Norfolk, VA 23505. The listed phone number is (757) 889-6520.

What is Family Physicians Of Tidewater PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Family Physicians Of Tidewater PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0685010) is associated with this NPI, valid through March 17, 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 Family Physicians Of Tidewater PLLC 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.