Tidewater Home Modifiers LLC

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Legal business name

TIDEWATER HOME MODIFIERS LLC

Practice address

206 Marina CT
Chesapeake, VA 23320-3402

Phone

(757) 618-4064

NPI assigned

Dec 28, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Chestley Thomas Cowling Jr.NPI 1992126122

Title

Owner/Member

Phone

(757) 618-4064

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chestley Thomas Cowling Jr.

  • Home Modifications Contractor
  • Chesapeake, VA
  • NPI 1992126122
  NPD (past) Authorized official

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

{
    "created_epoch": "1388188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388188800000",
    "number": "1104247733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MARINA CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203402",
            "telephone_number": "757-618-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARINA CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203402",
            "telephone_number": "757-618-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER HOME MODIFIERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-28",
        "last_updated": "2013-12-28",
        "status": "A",
        "authorized_official_last_name": "COWLING",
        "authorized_official_first_name": "CHESTLEY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "757-618-4064",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Modifications Contractor in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Home Modifications Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2013; 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.