Tidewater Orthopaedic Associates Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TIDEWATER ORTHOPAEDIC ASSOCIATES INC

Practice address

4037 Ironbound Rd
Williamsburg, VA 23188-2507

Phone

(757) 206-1004

Fax

(757) 645-3965

NPI assigned

Mar 29, 2007

Last updated

Mar 22, 2024By 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

Stacey Tanner Bell

Title

Ceo

Phone

(757) 827-2480

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1649399650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 ENTERPRISE PARKWAY",
            "address_2": "SUITE 900",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 IRONBOUND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882507",
            "telephone_number": "757-206-1004",
            "fax_number": "757-645-3965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7007 Harbour View Blvd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234353657",
            "country_code": "US",
            "telephone_number": "757-827-2480",
            "fax_number": "757-299-9917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Enterprise Pkwy Ste 900",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236666250",
            "country_code": "US",
            "telephone_number": "757-827-2480",
            "fax_number": "757-827-2566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3920A Bridge Rd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234351126",
            "country_code": "US",
            "telephone_number": "757-251-2971",
            "fax_number": "757-282-5848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TIDEWATER ORTHOPAEDIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "TANNER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-827-2480"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Jean Thompson, MASPED, BCBA, LBA
• Troy W Thompson, M.D.
• Jean-Paul Thorne, MA
• Laurel Breanne Thornton Bass, LCSW
• Thrive Therapy, LLC
• Tidewater Pain Management PC
• Tidewater Physical Therapy, LLC
• Tidewater Physical Therapy, LLC
• Tidewater Physical Therapy, LLC
• Tidewater Physicians Multispecialty Group PC (TPMG Williamsburg Urology, in Office Dispensing)

• Durable Medical Equipment & Medical Supplies in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.