Western Tidewater Free Clinic Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WESTERN TIDEWATER FREE CLINIC INC

Practice address

2019 Meade Pkwy
Suffolk, VA 23434-4259

Phone

(757) 923-1060

Fax

(757) 923-1068

NPI assigned

Sep 17, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Chester Marvin Hart

Title

Executive Director

Phone

(757) 923-1060

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Linda Kay Frey, N.P.

  • Family Medicine Physician
  • Suffolk, VA
  • NPI 1144251687
  NPD (past)

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1295219210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-923-1060",
            "fax_number": "757-923-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-923-1060",
            "fax_number": "757-923-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN TIDEWATER FREE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_middle_name": "MARVIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-923-1060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Tidewater Community Services Board
• Western Tidewater Community Services Board
• Western Tidewater Community Services Board
• Western Tidewater Community Services Board
• Western Tidewater Community Services Board
• Western Tidewater Health District
• Philip Francis Whalen, CRNA
• Patrick S Whelan, M.D.
• Thomas Vincent Whelan, MD
• Aaron Leon Whidbee

• All providers in Suffolk, VA
• General Practice Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.