NPIMap

Organization Active NPI

Spine Care of Tidewater, P.C.

  • Chiropractor
  • Hampton, VA
National Provider Identifier
1437296027
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000693 Issued in VA
Legal business name
SPINE CARE OF TIDEWATER, P.C.
Practice address
2204 Executive Dr
Suite a
Hampton, VA 23666-6602
Phone
(757) 827-3210
Fax
(757) 827-9089
NPI assigned
Jan 31, 2007
Last updated
Dec 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Authorized official

Name
Dr. Kevin J. Westby, D.C.NPI 1720198377
Title
President
Phone
(757) 827-3210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000693 VA Primary

Addresses

Primary practice location

2204 Executive Dr
Suite a
Hampton, VA 23666-6602

Mailing address

2204 Executive Dr
Suite a
Hampton, VA 23666-6602
Phone (757) 827-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070529000281 VA Part B Supplier - Clinic/Group Practice 9537266440 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hampton, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Spine Care of Tidewater PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2216 Executive Dr
Hampton, VA 23666
Phone (757) 896-3989

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1437296027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 EXECUTIVE DR",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666602",
            "telephone_number": "757-827-3210",
            "fax_number": "757-827-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 EXECUTIVE DR",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666602",
            "telephone_number": "757-827-3210",
            "fax_number": "757-827-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CARE OF TIDEWATER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "WESTBY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-827-3210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000693",
            "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 Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.