Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Rehabilitation Medicine

Organization Physical Medicine & Rehabilitation Physician · NPI 1891113155

Tidewater Rehabilitation Medicine is a Physical Medicine & Rehabilitation Physician in Virginia Beach, Virginia. Licensed in Virginia. Registered with an NPI since 2014.

Licensed in
VA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

1120 First Colonial Rd Ste 206
Virginia Beach, VA 23454-2418
Phone: (757) 496-2325
Fax: (757) 496-1942
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 0101053621 (VA)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 0101053621 (VA)

Record details

NPI number1891113155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Kayota — Sole Owner/Authorize Official · (757) 496-2325
NPI enumeratedApril 3, 2014
Last updated in NPPESApril 25, 2015
Mailing address1120 First Colonial Rd, Suite 206, Virginia Beach, VA 23454-2418

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