TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1215952361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215952361 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Other Organization Name | PIVOT PHYSICAL THERAPY OF VIRGINIA |
| Practice Address |
4020 Raintree Rd Ste D Chesapeake VA 23321-3749 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 7574844241 |
| Practice Fax Number | 7574844487 |
| Mailing Telephone | 9192582714 |
| Enumeration Date | 2006-07-12 |
| 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 | BCBS (PT) | 192941 | 01 |
| Other Name | Type Code |
|---|---|
| Pivot Physical Therapy of Virginia | Doing Business As Name - Organization |
| 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 |
4020 RAINTREE RD STE D |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23321-3749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497751762 | Ernest Aubrey Murden Jr. | Specialist | 4020 Raintree Rd, Ste C, Chesapeake, VA 23321-3749 | 2005-06-22 |
| 1588078711 | Jessica Pumphrey | Physician Assistant | 4020 Raintree Rd, Chesapeake, VA 23321-3749 | 2014-06-16 |
| 1457647976 | Teresa R Wright | Family Medicine | 4020 Raintree Rd, Suite B, Chesapeake, VA 23321 | 2011-06-22 |
| 1689837700 | Nurudeen S Lawani | Internal Medicine | 4020 Raintree Rd, Suite B, Chesapeake, VA 23321-3749 | 2008-07-09 |
| 1497881213 | Sharon Hooper Minor | Audiologist | 4020 Raintree Rd, Suite C, Chesapeake, VA 23321-3749 | 2007-02-26 |
| 1053447839 | Tidewater Ear, Nose, & Throat, Inc. | Specialist | 4020 Raintree Rd, Suite C, Chesapeake, VA 23321-3749 | 2007-02-26 |
| 1508893892 | Maryview Hospital | Internal Medicine | 4020 Raintree Rd, Suite B, Chesapeake, VA 23321-3749 | 2006-06-26 |
| 1073577300 | Elizabeth D Forrest | Internal Medicine | 4020 Raintree Rd, Suite B, Chesapeake, VA 23321-3749 | 2006-04-13 |
| 1467439737 | John D Ackiss | Physical Therapist | 4020 Raintree Rd, Suite D, Chesapeake, VA 23321-3749 | 2005-12-28 |
| 1104819812 | Kevin M. Hesse | Physical Therapist | 4020 Raintree Rd, Suite D, Chesapeake, VA 23321-3749 | 2005-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538475 | Yvonne Cotton | Social Worker | 3201 Churchland Blvd Suite 3, Chesapeake, VA 23321 | 2020-11-04 |
| 1073120242 | Peace In Life, LLC. | Custodial Care Facility | 3101 American Legion Road 21a, Chesapeake, VA 23321 | 2020-09-30 |
| 1497382337 | Diversified Transportation Solutions | Meals | 4940 Portsmouth Blvd. #222, Chesapeake, VA 23321 | 2020-03-23 |
| 1952895344 | Jasmine Wilkins | Private Vehicle | 4112 Jennifer Cres, Chesapeake, VA 23321 | 2018-06-19 |
| 1891219804 | P & S Home Health Care Solutions | Home Health | 3217 Western Branch Blvd, Suite B, Chesapeake, VA 23321 | 2017-08-01 |
| 1316467145 | Chelsea Ellison | Occupational Therapist | 3253 Taylor Rd Ste 200, Chesapeake, VA 23321 | 2017-06-22 |
| 1932655313 | Bhg Xli, LLC | Clinic/Center | 3322 Western Branch Blvd Ste A, Chesapeake, VA 23321 | 2016-08-26 |
| 1891189429 | Kelly C Diguilio | Social Worker | 4142 Chesapeake Square Blvd, Chesapeake, VA 23321 | 2015-03-20 |
| 1447665336 | Clancey Page | Behavioral Analyst | 4016 Raintree Rd Ste 200a, Chesapeake, VA 23321 | 2014-06-30 |
| 1558786228 | Mary Elizabeth Whitley | Home Health Aide | 3933 Galleon Dr., Chesapeake, VA 23321 | 2014-03-04 |
| Find all providers in zip 23321 | ||||
| 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 |
|---|---|---|---|---|
| 1710586979 | Kimberly Glymph | Physical Therapist | 510 Independence Pkwy Ste 850, Chesapeake, VA 23320-5196 | 2020-10-20 |
| 1063036879 | Gwendolyn Withers | Physical Therapist | 747 Volvo Pkwy Ste 103, Chesapeake, VA 23320-1615 | 2020-06-08 |
| 1043843667 | Sandra Federico | Physical Therapist | 3800 Poplar Hill Rd Ste B, Chesapeake, VA 23321-5522 | 2020-02-21 |
| 1003472184 | Edwin Bryce Lee | Physical Therapist | 1512 Technology Dr Ste 102, Chesapeake, VA 23320-5979 | 2019-05-14 |
| 1427516988 | Personal Touch Therapy | Physical Therapist | 1304 Dominion Lakes Blvd, Chesapeake, VA 23320-6451 | 2019-03-04 |
| 1013405737 | Kirsteen Mitchell | Physical Therapist | 2008 Dock Landing Rd, Chesapeake, VA 23321-3512 | 2018-04-27 |
| 1588011555 | Grant William Hessberger | Physical Therapist | 801 Poindexter St Ste 219, Chesapeake, VA 23324-2358 | 2016-05-19 |
| 1700233814 | William Merle Bosley | Physical Therapist | 909 New Mill Dr, Chesapeake, VA 23322-7087 | 2016-05-18 |
| 1184081283 | Beth Ackerman | Physical Therapist | 712 Remington Ct, Chesapeake, VA 23322-5487 | 2016-01-20 |
| 1205201738 | Sherita Wilson | Physical Therapist | 330 Riviara Pl, Chesapeake, VA 23322-6949 | 2015-12-09 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23321 |
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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.