Convenient Care of Tidewater

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101050282 Issued in VA

Legal business name

CONVENIENT CARE OF TIDEWATER

Practice address

113 Gainsborough SQ
Suite 103
Chesapeake, VA 23320-1713

Phone

(757) 549-0222

NPI assigned

Nov 12, 2006

Last updated

Jan 8, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony A Morris, MDNPI 1750452827

Title

President

Phone

(757) 549-0222

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony A Morris, MD

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1750452827
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1013088186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2518",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233272518",
            "telephone_number": "757-549-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GAINSBOROUGH SQ",
            "address_2": "SUITE 103",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201713",
            "telephone_number": "757-549-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT CARE OF TIDEWATER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-549-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101050282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "72637",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "104078",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004520572",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010041741",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "75063",
            "identifier": "MEDCO",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.