Plastic Surgery Associates of Tidewater

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024173410 Issued in VA

Legal business name

PLASTIC SURGERY ASSOCIATES OF TIDEWATER

Practice address

5818 Harbour View Blvd
Suite 200
Suffolk, VA 23435-3315

Phone

(757) 673-6000

Fax

(757) 673-6007

NPI assigned

Mar 22, 2016

Last updated

Mar 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Samantha Marie Persson, FNP-BC

Title

Nurse Practitioner

Phone

(540) 493-7759

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1528420429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-673-6000",
            "fax_number": "757-673-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-673-6000",
            "fax_number": "757-673-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY ASSOCIATES OF TIDEWATER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "PERSSON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "540-493-7759",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra L Pinon, M.D.
• Pinsri Care (Tranquil Manor)
• Corinda Pippins, PHARMD
• Caroline Coleson Pittman, AANP, FNP-C
• Latwanda Tenee Pittman, NURSE PRACTITIONER
• Plastic Surgery Specialist of Virginia, Inc.
• Platinum Home Health Care
• Platinum Home Health Care LLC
• Latoya Pledger, LCSW
• Mary-Beth Fennell Plum, PHARM.D., BCACP

• Family Nurse Practitioner in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.