Tidewater Endocrinology LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

0101034393 Issued in VA

Legal business name

TIDEWATER ENDOCRINOLOGY LLC

Doing business as

Endocrinology and Diabetes Center

Practice address

3205 Churchland Blvd
Chesapeake, VA 23321-5205

Phone

(757) 484-7822

Fax

(757) 484-7362

NPI assigned

Apr 16, 2014

Last updated

Jun 20, 2014By 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

Dr. James Calvin Larocque, M.D.NPI 1659462398

Title

Owner

Phone

(757) 484-7822

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ENDOCRINOLOGY AND DIABETES CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 4

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.

• James C Larocque, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Chesapeake, VA
  • NPI 1659462398
  Medicare reassignment NPD Authorized official
• Eileen Mary Gilman, FNP-C

  • Family Nurse Practitioner
  • Chesapeake, VA
  • NPI 1063681864
  Medicare reassignment NPD
• Loretta Arnel Richardson, DNP, RN

  • Family Nurse Practitioner
  • Chesapeake, VA
  • NPI 1437923299
  Medicare reassignment NPD
• Rokshana Raschid Thanadar, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Portsmouth, VA
  • NPI 1538321286
  Medicare reassignment NPD

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1639599723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215205",
            "telephone_number": "757-484-7822",
            "fax_number": "757-484-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215205",
            "telephone_number": "757-484-7822",
            "fax_number": "757-484-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER ENDOCRINOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "LAROCQUE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-484-7822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101034393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1639599723",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENDOCRINOLOGY AND DIABETES CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tidewater Emergency Medical Care, LTD. (Chesapeake Emergency Physicians)
• Tidewater Endocrine Consultants, PC
• Tidewater Family Medical Care, PC
• Tidewater Healthcare Services, Inc (Brightstar Healthcare)
• Tidewater Home Modifiers LLC
• Tidewater Internal Medicine and Hypertension Center. PLC
• Tidewater Medical Clinic PC

• Endocrinology, Diabetes & Metabolism Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.