Long Term Care Of Tidewater Pc - Medicare Primary Care in Norfolk, VA

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Long Term Care Of Tidewater Pc is a medicare enrolled primary clinic (Internal Medicine) in Norfolk, Virginia. The current practice location for Long Term Care Of Tidewater Pc is 6160 Kempsville Cir Ste 325a, Norfolk, Virginia. For appointments, you can reach them via phone at (757) 917-5356. The mailing address for Long Term Care Of Tidewater Pc is 110 Kingsley Ln Ste 312, Norfolk, Virginia and phone number is (757) 917-5356.

Long Term Care Of Tidewater Pc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1033154430. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (757) 917-5356.

Contact Information

Long Term Care Of Tidewater Pc
6160 Kempsville Cir Ste 325a
Norfolk
VA 23502-3933
(757) 917-5356
(757) 917-5141

Map and Direction


Primary Care Clinic Profile

Full NameLong Term Care Of Tidewater Pc
SpecialityInternal Medicine
Location6160 Kempsville Cir Ste 325a, Norfolk, Virginia
Authorized Official Name and PositionJayne Walter (CREDENTIALING)
Authorized Official Contact7579175356
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Long Term Care Of Tidewater Pc
110 Kingsley Ln Ste 312
Norfolk
VA 23505-4618

Ph: (757) 917-5356		Long Term Care Of Tidewater Pc
6160 Kempsville Cir Ste 325a
Norfolk
VA 23502-3933

Ph: (757) 917-5356

NPI Details:

NPI Number1033154430
Provider Enumeration Date06/19/2006
Last Update Date11/01/2019

Medicare PECOS Information:

Medicare PECOS PAC ID4385639343
Medicare Enrollment IDO20040419000964

Medical Identifiers

Medical identifiers for Long Term Care Of Tidewater Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033154430NPI-NPPES
CK3562OtherVARAILROAD MEDICARE GROUP #

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary
207RG0300XInternal Medicine - Geriatric Medicine (* (Not Available))Secondary
207RN0300XInternal Medicine - Nephrology (* (Not Available))Secondary
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Long Term Care Of Tidewater Pc acts as a billing entity for following providers:
Provider NameFrances Anagnost-holladay Williams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003894270
PECOS PAC ID: 9537061387
Enrollment ID: I20040122001078
Provider NameChristine Daley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356514947
PECOS PAC ID: 9931197852
Enrollment ID: I20040430001260
Provider NameNiraj Patel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1932145422
PECOS PAC ID: 8628069382
Enrollment ID: I20040520001316
Provider NameJohn Timothy Carmack
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1023034972
PECOS PAC ID: 4789663964
Enrollment ID: I20040720000703
Provider NameKaren K Frye
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578660767
PECOS PAC ID: 6406820984
Enrollment ID: I20040820000849
Provider NameZewditu Tekleberhan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1336100973
PECOS PAC ID: 4486606928
Enrollment ID: I20050214000263
Provider NameJaskiran G Singh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164480364
PECOS PAC ID: 0941248496
Enrollment ID: I20050425000508
Provider NameLakshmi R Chaudhuri
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659351377
PECOS PAC ID: 4183662653
Enrollment ID: I20050425000674
Provider NameKatherine Poe Caton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174534416
PECOS PAC ID: 6002827680
Enrollment ID: I20060510000394
Provider NameLeslie S Hodeen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649215575
PECOS PAC ID: 5395748685
Enrollment ID: I20060804000175
Provider NameGilda Niknezhad
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245330190
PECOS PAC ID: 0941303507
Enrollment ID: I20070320000233
Provider NameJennifer L Fellman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316982457
PECOS PAC ID: 4183728595
Enrollment ID: I20070323000484
Provider NameDorothy R Critzer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427254465
PECOS PAC ID: 6103919758
Enrollment ID: I20070912000567
Provider NamePedro D Hasas
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871560110
PECOS PAC ID: 0446345821
Enrollment ID: I20070929000132
Provider NameCourtney Brooke Bass
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154514891
PECOS PAC ID: 0143310482
Enrollment ID: I20071226000340
Provider NameMigdonia Montejo
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1467459347
PECOS PAC ID: 2062593080
Enrollment ID: I20080116000376
Provider NameNancy Lynn Hopkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235322439
PECOS PAC ID: 2264519206
Enrollment ID: I20080401000859
Provider NameMohammad R Abolhassani
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1932297702
PECOS PAC ID: 8921909664
Enrollment ID: I20080417000454
Provider NameDawn A Freeman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033381587
PECOS PAC ID: 8426120494
Enrollment ID: I20080708000494
Provider NameJulie A Mclean
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265630933
PECOS PAC ID: 6901999861
Enrollment ID: I20090520000299
Provider NameAntoine A Arrage
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1013997733
PECOS PAC ID: 2668527805
Enrollment ID: I20090911000237
Provider NameMichelle H Mobley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386744258
PECOS PAC ID: 3476609827
Enrollment ID: I20090925000517
Provider NameImtiaz Zaman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1013078286
PECOS PAC ID: 6103968367
Enrollment ID: I20100126000642
Provider NameMarilyn S Kellam
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1497740641
PECOS PAC ID: 1951482421
Enrollment ID: I20100225000438
Provider NamePriyanka A Patel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1154558997
PECOS PAC ID: 1850588260
Enrollment ID: I20101210000973
Provider NameZelda Fulgham
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215226071
PECOS PAC ID: 7810171972
Enrollment ID: I20110414000103
Provider NameHarvey H Bercowitz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1801864566
PECOS PAC ID: 4981888062
Enrollment ID: I20110414000328
Provider NameKavitha Tatineni
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568754604
PECOS PAC ID: 5799961249
Enrollment ID: I20110517000617
Provider NameShirley Dodson-mcadoo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285873315
PECOS PAC ID: 7416005319
Enrollment ID: I20110518000451
Provider NameCarolyn E Ingram
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659660538
PECOS PAC ID: 9335326362
Enrollment ID: I20110531000558
Provider NameRobert E Walters
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174503890
PECOS PAC ID: 2668559337
Enrollment ID: I20120105000247
Provider NameBarbara L Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144200858
PECOS PAC ID: 5294812962
Enrollment ID: I20120112000440
Provider NameSarah Kimberly Kosinski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982987301
PECOS PAC ID: 3274799184
Enrollment ID: I20120723000021
Provider NameLatara C Carney Harris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508125352
PECOS PAC ID: 2365699352
Enrollment ID: I20120827000465
Provider NameDonna B Dowell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144579749
PECOS PAC ID: 7911155155
Enrollment ID: I20120913000479
Provider NameJennifer L Furlow
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770845968
PECOS PAC ID: 6507016094
Enrollment ID: I20121018000105
Provider NameNina L Jernigan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245523638
PECOS PAC ID: 6901036607
Enrollment ID: I20140225000903
Provider NameTheresa M Wright
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376933754
PECOS PAC ID: 9638497852
Enrollment ID: I20150417001297
Provider NameHeather Mitchell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992175095
PECOS PAC ID: 5496065849
Enrollment ID: I20151116000041
Provider NameSasha A Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942665054
PECOS PAC ID: 4284939307
Enrollment ID: I20160226000740
Provider NameJonee Marie Purvis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417312133
PECOS PAC ID: 9537467451
Enrollment ID: I20160411000113
Provider NameJuanita M Norwood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043616741
PECOS PAC ID: 4486948148
Enrollment ID: I20160803002787
Provider NameNicholas W White
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437492105
PECOS PAC ID: 4688968571
Enrollment ID: I20160816001942
Provider NameJohnnie Faye Lawrimore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245786722
PECOS PAC ID: 3173803699
Enrollment ID: I20161129001274
Provider NameAngel M Williams-kent
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598219214
PECOS PAC ID: 2961782859
Enrollment ID: I20161212001414
Provider NameAlexis J Chappell
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1992190912
PECOS PAC ID: 2466733381
Enrollment ID: I20170106001314
Provider NameYvette J Hunter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164968947
PECOS PAC ID: 2567739378
Enrollment ID: I20170530000071
Provider NameGerlene Sherard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649722505
PECOS PAC ID: 6901176130
Enrollment ID: I20170721000270
Provider NameShannon Coulson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295237477
PECOS PAC ID: 8325303951
Enrollment ID: I20180531000321
Provider NameMarcelli Pascal-rodriguez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518480045
PECOS PAC ID: 1254680523
Enrollment ID: I20180820001907
Provider NameIen A Rodriguez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417448796
PECOS PAC ID: 8628327483
Enrollment ID: I20180828001475
Provider NameDebbie V Greenidge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679051684
PECOS PAC ID: 5890048102
Enrollment ID: I20181101002791
Provider NameHolly A Maddox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760950331
PECOS PAC ID: 7719222314
Enrollment ID: I20190102000751
Provider NameKathleen Stornelli
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1275695793
PECOS PAC ID: 3577689959
Enrollment ID: I20190325000195

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.