NPIMap

Organization Active NPI

Tidewater Heart Laboratories

  • Specialist
  • Hampton, VA
National Provider Identifier
1164613543
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TIDEWATER HEART LABORATORIES
Practice address
2116 Executive Dr
Hampton, VA 23666-2402
Phone
(757) 224-4233
Fax
(757) 224-4955
NPI assigned
Aug 9, 2007
Organization subpart
Yes
Parent organization
TIDEWATER HEART INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Mrs. Bonnie Herring
Title
Office Administator
Phone
(757) 825-4260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X VA Primary

Addresses

Primary practice location

2116 Executive Dr
Hampton, VA 23666-2402

Mailing address

2115 Executive Dr
Suite 1B
Hampton, VA 23666
Phone (757) 825-4260

National Provider Directory

National Provider Directory
Part of
Tidewater Heart Laboratories

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1164613543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 EXECUTIVE DR",
            "address_2": "SUITE 1B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-825-4260",
            "fax_number": "757-825-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-224-4233",
            "fax_number": "757-224-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER HEART LABORATORIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIDEWATER HEART INSTITUTE",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "HERRING",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OFFICE ADMINISTATOR",
        "authorized_official_telephone_number": "757-825-4260",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.