Tidal Family Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002263 Issued in VA

Legal business name

TIDAL FAMILY EYE CARE, LLC

Practice address

12300 Jefferson Ave
Suite 500
Newport News, VA 23602-6900

Phone

(757) 249-0281

NPI assigned

Jan 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Martha K Overmeyer, O.D.

Title

Owner

Phone

(757) 249-0281

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1154742427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 JEFFERSON AVE",
            "address_2": "SUITE 500",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236026900",
            "telephone_number": "757-249-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 JEFFERSON AVE",
            "address_2": "SUITE 500",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236026900",
            "telephone_number": "757-249-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDAL FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "OVERMEYER",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-249-0281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Newport News, VA
• Providers in Newport News, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.