Organization Active NPI

Gastrointestinal and Liver Specialists of Tidewater PLLC

  • Gastroenterology Physician
  • Virginia Beach, VA
National Provider Identifier
1891338745
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC
Practice address
1101 First Colonial Rd Ste 400
Virginia Beach, VA 23454-2409
Phone
(757) 481-4817
Fax
(757) 481-7138
NPI assigned
Oct 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Authorized official

Name
Gladys Arlene Davies
Title
Administrator
Phone
(757) 464-1644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1101 First Colonial Rd Ste 400
Virginia Beach, VA 23454-2409

Mailing address

1101 First Colonial Rd Ste 400
Virginia Beach, VA 23454-2409
Phone (757) 481-4817

Other names 2

  • Gastroenterology, Ltd Doing business as
  • Gastroenterology, Ltd. Doing business as

National Provider Directory

National Provider Directory

Locations

113 Gainsborough Sq
Ste 100
Chesapeake, VA 23320
Phone (757) 436-3285

400 Gresham Dr
Ste 303
Norfolk, VA 23507
Phone (757) 627-3709

3640 High St
Ste 2G
Portsmouth, VA 23707
Phone (757) 483-6100

5839 Harbour View Blvd
Ste 200
Suffolk, VA 23435
Phone (757) 483-6100

5320 Providence Rd
Ste 204
Virginia Beach, VA 23464
Phone (757) 523-9755

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": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1891338745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-4817",
            "fax_number": "757-481-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-4817",
            "fax_number": "757-481-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROINTESTINAL AND LIVER SPECIALISTS OF TIDEWATER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-464-1644"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gastroenterology, Ltd",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gastroenterology, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 23, 2019; 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.