Active NPI
Tidewater Heart Specialists, Inc.
- Specialist
- Hampton, VA
National Provider Identifier
1417992686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- TIDEWATER HEART SPECIALISTS, INC.
- Practice address
- 2112 Hartford Rd Ste B
Hampton, VA 23666-6601 - Phone
- (757) 827-7754
- NPI assigned
- Jun 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark W Clark, M.D.
- Title
- President
- Phone
- (757) 827-7754
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | VA | Primary |
Addresses
Primary practice location
2112 Hartford Rd Ste B
Hampton, VA 23666-6601
Mailing address
2112 Hartford Rd Ste B
Hampton, VA 23666-6601
National Provider Directory
National Provider DirectoryLocations
2112 Hartford Rd
Hampton, VA 23666
Phone (757) 826-7516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1417992686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 HARTFORD RD STE B",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236666601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 HARTFORD RD STE B",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236666601",
"telephone_number": "757-827-7754"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIDEWATER HEART SPECIALISTS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-19",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "757-827-7754",
"authorized_official_credential": "M.D."
},
"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
- Tidewater Diagnostic Imaging LTD
- Tidewater Family Health Centers, LTD.
- Tidewater Family Medicine, P C
- Tidewater Heart Institute Inc
- Tidewater Heart Laboratories
- Tidewater Internal Medicine Associates, P.C.
- Tidewater Orthopaedic Associates
- Tidewater Orthopaedic Associates Inc
- Tidewater Orthopaedic Associates Inc
- Tidewater Orthopaedic Associates Occupational Therapy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.