NPIMap

Organization Active NPI

Mid-Atlantic Womens Care PLC

  • Counselor
  • Virginia Beach, VA
National Provider Identifier
1609110774
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1701004447 Issued in VA
Legal business name
MID-ATLANTIC WOMENS CARE PLC
Practice address
828 Healthy Way
Suite 330
Virginia Beach, VA 23462-7958
Phone
(757) 461-3890
Fax
(757) 467-0301
NPI assigned
Nov 15, 2012
Organization subpart
Yes
Parent organization
MID-ATLANTIC WOMENS CARE PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Rex G Waterbury, MD
Title
Physician
Phone
(757) 461-3890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 1701004447 VA Primary

Addresses

Primary practice location

828 Healthy Way
Suite 330
Virginia Beach, VA 23462-7958

Mailing address

828 Healthy Way
Suite 330
Virginia Beach, VA 23462-7958
Phone (757) 461-3890

Other identifiers 1

IdentifierTypeStateIssuer
C05062OtherVAC05062

National Provider Directory

National Provider Directory
Tax ID family
Tidewater Phys for Wome6 organizations share this tax ID, including this one
Part of
Tidewater Phys for Wome

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1609110774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 HEALTHY WAY",
            "address_2": "SUITE 330",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234627958",
            "telephone_number": "757-461-3890",
            "fax_number": "757-467-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 HEALTHY WAY",
            "address_2": "SUITE 330",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234627958",
            "telephone_number": "757-461-3890",
            "fax_number": "757-467-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC WOMENS CARE PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID-ATLANTIC WOMENS CARE PLC",
        "enumeration_date": "2012-11-15",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "WATERBURY",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "757-461-3890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "VA",
            "license": "1701004447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C05062",
            "identifier": "C05062",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.