Davita Tidewater - Virginia Beach, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

DAVITA TIDEWATER - VIRGINIA BEACH, LLC

Doing business as

Camelot Dialysis Center

Practice address

1800 Camelot Dr
Ste 100
Virginia Beach, VA 23454-2440

Phone

(757) 481-6879

Fax

(757) 496-0187

NPI assigned

Jul 5, 2006

Last updated

May 18, 2026By 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

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Camelot Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Tax ID family

Camelot Dialysis2 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.

• Davita Tidewater - Virginia Beach, LLC

  dba Camelot Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Virginia Beach, VA
  • NPI 1710066428
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers Mid Atlantic Inc

  dba Grovepark Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jackson, GA
  • NPI 1558330522

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1689605008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR",
            "address_2": "STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-481-6879",
            "fax_number": "757-496-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA TIDEWATER - VIRGINIA BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689605008",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Camelot Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Toquise Davis
• Vernice I Davis, LPC
• William James Davis, INDEPENDENT DUTY COR
• Mary Carole Davis'Libre, LPC
• Christie Davison
• Davita Tidewater - Virginia Beach, LLC (Camelot Dialysis)
• Raven Dawkins
• Rhiannon Dawson
• Day Home Care LLC (First Day Homecare #004)
• Amir Yasiin Day

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.