Hightide Healthcare PLLC

Organization Active NPI Family Medicine Physician · Kitty Hawk, NC

NPI 1376403147 · NPPES record last updated Apr 3, 2026

Key facts

NPI
1376403147
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
HIGHTIDE HEALTHCARE PLLC
Practice address
5200 N Croatan Hwy Ste 9
Kitty Hawk, NC 27949-3990
Phone
(757) 515-8071
NPI assigned
Nov 14, 2025
Organization subpart
No

Authorized official

Name
Leah H Woolridge
Title
Owner/FNP
Phone
(252) 581-8404

Practitioners 4

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2342298Hightide Healthcare PLLC
5200 N Croatan Hwy Suite 9, Kitty Hawk, NC 27949
Certificate of waiverApr 16, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260115000989 NC Part B Supplier - Clinic/Group Practice 3375029705 Receives reassigned benefits from 4 practitioners
Practice locations: Kitty Hawk, NC

National Provider Directory

Locations

5200 N Croatan Hwy
Ste 9
Kitty Hawk, NC 27949
Phone (252) 581-8404

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

5200 N Croatan Hwy Ste 9
Kitty Hawk, NC 27949-3990

Mailing address

PO Box 1048
Kitty Hawk, NC 27949-1048
Phone (252) 581-8404

Other providers in Kitty Hawk, NC

All providers in Kitty Hawk, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.