TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1093172181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093172181 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Practice Address |
1745 Camelot Dr Suite 100 Virginia Beach VA 23454-2435 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 7579614800 |
| Practice Fax Number | 7579610233 |
| Mailing Telephone | 9192582714 |
| Enumeration Date | 2016-01-21 |
| 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 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP PTAN | C05954 | 01 |
| 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 |
1745 CAMELOT DR SUITE 100 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609838085 | Udaya Kumar Shetty | Psychiatry & Neurology | 1745 Camelot Dr, Virginia Beach, VA 23454-2435 | 2006-04-03 |
| 1699155796 | Marley Anderson | Physical Therapist | 1745 Camelot Dr, Virginia Beach, VA 23454-2435 | 2015-06-03 |
| 1124127873 | Kelly C Desmond | Dietitian, Registered | 1745 Camelot Dr, Virginia Beach, VA 23454-2435 | 2006-09-21 |
| 1710901632 | David C Mcginness | Social Worker | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-07-26 |
| 1548287253 | Behavioral & Neuropsychiatric Group, Inc | Counselor | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-07-17 |
| 1588621171 | John Tonry | Counselor | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-04-27 |
| 1538126370 | Pamela K Zane | Psychologist | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-04-26 |
| 1578529509 | Clare Tonry | Counselor | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-04-26 |
| 1689638819 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 1745 Camelot Dr, Ste 100, Virginia Beach, VA 23454-2435 | 2006-04-14 |
| 1164485165 | Donald C Meekings | Counselor | 1745 Camelot Dr, Suite 200, Virginia Beach, VA 23454-2435 | 2006-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| 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 |
|---|---|---|---|---|
| 1730789108 | Chelsea Rae Edmondson | Physical Therapist | 2728 Virginia Beach Blvd, Virginia Beach, VA 23452-7615 | 2020-10-27 |
| 1386243004 | Amanda Lin Bliek | Physical Therapist | 816 Independence Blvd Ste 3f, Virginia Beach, VA 23455-6010 | 2020-10-23 |
| 1326655937 | Coastal Therapy Group Inc | Physical Therapist | 1100 Laskin Rd, Virginia Beach, VA 23451-5274 | 2020-09-28 |
| 1619596905 | Re Active Therapy and Wellness Pllc | Physical Therapist | 2624 Lotus Creek Dr, Virginia Beach, VA 23456-6461 | 2020-04-16 |
| 1972147676 | Jose Rivera Paredes Jr. | Physical Therapist | 5612 Rushmere Dr, Virginia Beach, VA 23464-6751 | 2019-11-05 |
| 1427619097 | David Furrow | Physical Therapist | 2247 W Great Neck Rd, Virginia Beach, VA 23451-1556 | 2019-06-25 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1396301560 | Bethany Labossier | Physical Therapist | 2117 Mccomas Way Ste 105, Virginia Beach, VA 23456-3908 | 2019-05-14 |
| 1881186450 | Kiley Fletcher | Physical Therapist | 2247 W Great Neck Rd Ste 101, Virginia Beach, VA 23451-1556 | 2018-05-30 |
| 1841797263 | Alysia Rae Parker | Physical Therapist | 5604 Virginia Beach Blvd Unit A, Virginia Beach, VA 23462-5631 | 2018-04-11 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
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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.