TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1003114083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003114083 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Practice Address |
4831 S Laburnum Ave Richmond VA 23231-2713 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 8042220746 |
| Practice Fax Number | 8042220728 |
| Mailing Telephone | 9192582714 |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2020-05-05 |
| Authorized Official Name | PENNY PEARSON (RCM DIRECTOR) |
| Authorized Official Telephone | 4432254492 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 225100000X | Physical Therapist | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270973 | Tidewater Physical Therapy, LLC | Physical Therapist | 392 Garrisonville Rd Ste 208, Stafford, VA 22554-1576 | 2018-06-29 |
| 1942703491 | Tidewater Physical Therapy, LLC | Physical Therapist | 872 Prices Fork Rd, Blacksburg, VA 24060-3229 | 2018-03-12 |
| 1609004571 | Tidewater Physical Therapy, LLC | Occupational Therapist | 3510 Anderson Hwy, Suite 2, Powhatan, VA 23139 | 2009-06-30 |
| 1669627048 | Tidewater Physical Therapy, LLC | Occupational Therapist | 10438 Iron Bridge Rd Unit 34, Chester, VA 23831-1427 | 2008-11-26 |
| 1265501696 | Tidewater Physical Therapy, LLC | Occupational Therapist | 2004 Sandbridge Rd, Suite 102, Virginia Beach, VA 23456-4084 | 2006-11-07 |
| 1821192220 | Tidewater Physical Therapy, LLC | Occupational Therapist | 227 Wadsworth Dr, Richmond, VA 23236-4510 | 2006-09-08 |
| 1942229901 | Tidewater Physical Therapy, LLC | Occupational Therapist | 4125 Ironbound Rd Ste 101, Williamsburg, VA 23188-2666 | 2006-07-19 |
| 1467471896 | Tidewater Physical Therapy, LLC | Occupational Therapist | 12494 Warwick Blvd, Newport News, VA 23606-3000 | 2006-07-18 |
| 1477588986 | Tidewater Physical Therapy, LLC | Occupational Therapist | 10128 W Broad St, Forum Building IIi, Suite K, Glen Allen, VA 23060-6761 | 2006-07-12 |
| 1508898354 | Tidewater Physical Therapy, LLC | Occupational Therapist | 300 B Temple Lake Drive, Suite 1, Colonial Heights, VA 23834-2938 | 2006-07-06 |
| Street Address |
4831 S LABURNUM AVE |
| City | RICHMOND |
| State | VA |
| Zip Code | 23231-2713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467540385 | James Russell Miller | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2006-10-10 |
| 1497394001 | Kala Robert | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2019-12-30 |
| 1043869589 | Matthew Shane Harville | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2019-09-07 |
| 1205314218 | Brandon Shane Reynolds | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2018-08-01 |
| 1346617719 | Nicholas Klein | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2015-09-01 |
| 1265836795 | Emily N. Mehrer | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2014-10-13 |
| 1366796112 | Jonathan A Ebersole | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2012-11-01 |
| 1235484197 | Fegan H. Richmond | Physical Therapist | 4831 S Laburnum Ave, Richmond, VA 23231-2713 | 2012-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524766 | Latoya Steward | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 805 Admiral Gravely Blvd, Richmond, VA 23231 | 2020-10-07 |
| 1548721160 | Ray E Hill Jr. | Non-emergency Medical Transport (VAN) | 9469 Barrett Pl, Richmond, VA 23231 | 2019-03-27 |
| 1265922314 | Bon Secours - Richmond Community Hospital, Incorporated | Pediatrics | 4744 Finlay St, Richmond, VA 23231 | 2018-05-15 |
| 1225371743 | Vantage Point Community Supports, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8005 Diamond Ridge Court, Henrico, VA 23231 | 2013-04-03 |
| 1255586277 | Bon Secours - Richmond Community Hospital, Incorporated | Clinic/Center | 4630 S. Laburnum Ave., Suite C, Richmond, VA 23231 | 2008-11-18 |
| 1407050982 | Tawana Toneke Olds-davis | Counselor | 4305 Hillbrook Ave, Richmond, VA 23231 | 2007-06-11 |
| 1891814844 | East End Pediatrics, P.C. | Pediatrics | 4744 Finlay Street, Richmond, VA 23231 | 2007-03-29 |
| 1235229113 | Aunt Anns Home for Adolescents | Counselor | 5901 Almond Creek N Lane, Richmond, VA 23231 | 2006-10-13 |
| 1962500421 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5100 South Laburnum Ave Laburnum Sq, Richmond, VA 23231 | 2006-09-20 |
| 1043243546 | Bon Secours-virginia Healthsource | Family Medicine | 4835 S Laburnum Ave, Richmond, VA 23231 | 2006-07-08 |
| Find all providers in zip 23231 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422965 | Chandler Hagan Mcpherson | Physical Therapist | 1400 Gibson Bay Dr, Richmond, KY 40475-3800 | 2020-09-16 |
| 1518589902 | Pelvic Prana, LLC | Physical Therapist | 8 N Robinson St, Richmond, VA 23220-4430 | 2020-05-08 |
| 1407480882 | Stephen V Teng | Physical Therapist | 1500 Jackson St Ste 400, Richmond, TX 77469-3250 | 2020-02-25 |
| 1548804958 | Industrial Health, LLC | Physical Therapist | 9019 W Broad St, Richmond, VA 23294-5809 | 2019-10-30 |
| 1508426164 | Matthew Tyler Ward | Physical Therapist | 5899 Bremo Rd Ste 100b, Richmond, VA 23226-1935 | 2019-06-17 |
| 1255998837 | Kavitha Parasumanna Janarthanaa | Physical Therapist | 16806 Lessels Ln, Richmond, TX 77407-2258 | 2019-05-20 |
| 1467018101 | Chelsea Mannion | Physical Therapist | 20 S Boulevard Apt 4, Richmond, VA 23220-5797 | 2019-05-17 |
| 1578020111 | Aloysius Cabatingan | Physical Therapist | 22607 Duncan Brush Trce, Richmond, TX 77469-4766 | 2019-03-01 |
| 1952867509 | Confident Living Home Therapy Consulting LLC | Physical Therapist | 1276 Concord Ave, Richmond, VA 23228-6518 | 2019-02-19 |
| 1962968115 | Daily Touch LLC | Physical Therapist | 8900 Three Chopt Rd Ste D, Richmond, VA 23229-4615 | 2019-02-13 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.