OrganizationActive
Tidewater Medspa PLLC
NPI 1356099113 · Health Service Clinic/Center · Portsmouth, VA
Provider details
- NPI number
- 1356099113
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Margot Wilson, Owner(757) 470-9454
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
3400 Airline Blvd
Portsmouth, VA 23701-2623
Phone: (757) 470-9454
Street-level locationGet directions
Mailing address
3400 Airline Blvd
Portsmouth, VA 23701-2623
Registry dates
- Enumerated
- 2022-03-11
- Last updated
- 2022-03-11
- Certified
- 2022-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.