NPIMap

Individual provider Active NPI

Austin Lyle Parker, M.D.

  • Nephrology Physician
  • Kings Bay, GA
National Provider Identifier
1376513796
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101234675 Issued in VA
Practice address
881 Uss James Madison Rd
NSSC Undersea Medical Department
Kings Bay, GA 31547-2531
Phone
(912) 573-2995
Fax
(912) 573-4534
NPI assigned
Jan 26, 2006
Last updated
Sep 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101234675 VA
Nephrology Physician 207RN0300X 0101234675 VA Primary

Addresses

Primary practice location

881 Uss James Madison Rd
NSSC Undersea Medical Department
Kings Bay, GA 31547-2531

Mailing address

Nmrtc Portsmouth - Nephrology Clinic
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone (757) 953-2051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805000771 VA Practitioner - NephrologyPractitioner - Internal Medicine 3173705845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidewater Kidney Specialists IncGroup PAC ID 6507852662, 21 clinicians

Practice addresses (Care Compare)

814 Kempsville Rd
Suite 102
Norfolk, VA 23502-4001
Phone (757) 623-0005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
69.68
Promoting interoperability
100
Improvement activities
40
Cost
74.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101234675VAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Kidney Specialists, Inc. Nephrology CurrentSince Jul 1, 2024 Accepting new patients
Tidewater Kidney Specialists, Inc. Nephrology CurrentSince Jul 1, 2024 Accepting new patients

Locations

301 Riverview Ave
Ste 512
Norfolk, VA 23510
Phone (757) 627-5116

814 Kempsville Rd
Bldg 17
Norfolk, VA 23502
Phone (757) 893-1413

814 Kempsville Rd
Ste 102
Norfolk, VA 23502

4445 Corporation Ln
Ste 100
Virginia Beach, VA 23462

Interoperability endpoints

  • Direct secure messaging: austinparker@tks.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1376513796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NMRTC PORTSMOUTH - NEPHROLOGY CLINIC",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-2051",
            "fax_number": "757-953-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 USS JAMES MADISON RD",
            "address_2": "NSSC UNDERSEA MEDICAL DEPARTMENT",
            "city": "KINGS BAY",
            "state": "GA",
            "postal_code": "315472531",
            "telephone_number": "912-573-2995",
            "fax_number": "912-573-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "AUSTIN",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-09-23",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101234675",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101234675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Bay, GA

Sources for this page

Verify at the official NPI Registry.