OrganizationActive
Tidewater Rehabilitation Medicine
NPI 1891113155 · Pain Medicine (Physical Medicine & Rehabilitation) Physician · Virginia Beach, VA
Provider details
- NPI number
- 1891113155
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stephen Kayota, Sole Owner/Authorize Official(757) 496-2325
- License
- 0101053621 (VA)
Specialties & taxonomies
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081P2900XLicense 0101053621 (VA)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1120 First Colonial Rd
Suite 206
Virginia Beach, VA 23454-2418
Phone: (757) 496-2325
Fax: (757) 496-1942
Approximate (ZIP-level) locationGet directions
Mailing address
1120 First Colonial Rd
Virginia Beach, VA 23454-2418
Registry dates
- Enumerated
- 2014-04-03
- Last updated
- 2015-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.