TIDEWATER REHABILITATION MEDICINE
NPI 1891113155
Physical Medicine & Rehabilitation - Pain Medicine in Virginia Beach, VA

Q: What is Tidewater Rehabilitation Medicine's NPI number?

The NPI number for Tidewater Rehabilitation Medicine is 1891113155. It was assigned to this organization in the NPPES registry on April 3, 2014.

Q: What is Tidewater Rehabilitation Medicine's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Active since April 03, 2014

1120 FIRST COLONIAL RD, SUITE 206, VIRGINIA BEACH, VA 23454(757) 496-2325(757) 496-1942 Get Directions Write a Review

NPPES record last updated: April 25, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tidewater Rehabilitation Medicine NPPES

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

TIDEWATER REHABILITATION MEDICINE (NPI 1891113155) is a healthcare organization registered as a pain medicine in Virginia Beach, Virginia and active in the NPI registry since April 2014. The organization lists Stephen Walter Kayota, Sole Owner/authorize Official, as its authorized official.

NPPES Registry Identity

NPI1891113155

Entity TypeOrganization

Primary Taxonomy2081P2900X

Legal Business NameTIDEWATER REHABILITATION MEDICINE

Location Address1120 FIRST COLONIAL RD, SUITE 206Virginia Beach, VA 23454-2418

Mailing Address1120 First Colonial Rd, Suite 206Virginia Beach, VA 23454-2418 · (757) 496-2325 · Fax (757) 496-1942

Phone(757) 496-2325

Fax(757) 496-1942

Organization SubpartNo

Authorized OfficialStephen Walter KayotaSole Owner/authorize Official · (757) 496-2325

Enumeration DateApril 3, 2014

Last NPPES UpdateApril 25, 2015

✔ NPI 1891113155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P2900X

License✔ Licensed in VA · 0101053621

Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 0101053621 (VA)

1120 FIRST COLONIAL RD, Virginia Beach, VA 23454

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Other Identifiers 12

Other1891113155VA · United Healthcare

Other1891113155VA · Aetna

Other1891113155VA · Anthem Bcbs Va

Other618120600VA · Department Of Labor

Other1891113155VA · Cigna

Other1891113155VA · Virginia Health Network

Other1891113155VA · Humana Medicare

Other1891113155VA · Coventry

Medicare PIND620VA

Other1891113155VA · Optima

Other1891113155VA · Tricare

Medicaid1891113155VA

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 MULTIPLE SINGLE SPECIALTY GROUP

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.

GEORGE MARSHALL KEMP MD

Obstetrics & Gynecology (Gynecology)

1120 FIRST COLONIAL RD, SUITE 202
VIRGINIA BEACH, VA 23454

Virginia Beach City (757) 481-0327

MRS. NICOLE YVONNE HORN PAC

Physician Assistant (Medical)

1120 FIRST COLONIAL RD, SUITE100
VIRGINIA BEACH, VA 23454

Virginia Beach City (757) 481-2333

DR. GEORGE BULLARD JR. M.D.

Family Medicine