OrganizationActive
Tidewater Kidney Specialists, Inc.
NPI 1053678839 · Nephrology Physician · Norfolk, VA
Provider details
- NPI number
- 1053678839
- Entity type
- Organization
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Elizabeth Skidmore, Practice Administrator(757) 623-0005
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Vascular Surgery Physician2086S0129X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
814 Kempsville Rd
Suite 101
Norfolk, VA 23502-4001
Phone: (757) 623-0005
Fax: (757) 548-1129
Street-level locationGet directions
Mailing address
4445 Corporation Ln Ste 100
Virginia Beach, VA 23462-3666
Other names (DBA / former)
- Doing business as
- Tidewater Vascular Access Center
- Doing business as
- Tidewater Vascular Access Center
Registry dates
- Enumerated
- 2012-04-18
- Last updated
- 2022-01-20
- Certified
- 2022-01-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.