TIDEWATER PHYSICAL THERAPY LLC (NPI# 1386679595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386679595 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY LLC |
| Practice Address |
9980 Brook Rd Unit 16 Glen Allen VA 23059-6501 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 8045505730 |
| Practice Fax Number | 8045505733 |
| Mailing Telephone | 9192582714 |
| Mailing Fax Number | 4106484878 |
| 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 (OT) | 192970 | 01 |
| VA | BCBS (PT) | 192969 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497244800 | Tidewater Physical Therapy LLC | Physical Therapist | 5629 Plank Rd Ste 107, Fredericksburg, VA 22407-7216 | 2018-05-02 |
| 1659876407 | Tidewater Physical Therapy LLC | Physical Therapist | 15331 Creativity Dr Ste 960, Culpeper, VA 22701-2502 | 2018-03-26 |
| 1558869784 | Tidewater Physical Therapy LLC | Physical Therapist | 44 Broad Street Rd, Manakin Sabot, VA 23103-2213 | 2018-01-23 |
| 1972001147 | Tidewater Physical Therapy LLC | Physical Therapist | 2925 Polo Pkwy, Midlothian, VA 23113-1453 | 2018-01-23 |
| 1588172993 | Tidewater Physical Therapy LLC | Physical Therapist | 229 Connor Dr, Charlottesville, VA 22911-5604 | 2018-01-19 |
| 1124533609 | Tidewater Physical Therapy LLC | Physical Therapist | 2400 Lakeside Drive, Suite 602f, Lynchburg, VA 24501 | 2017-12-06 |
| 1861906166 | Tidewater Physical Therapy LLC | Physical Therapist | 1149 Jefferson Davis Hwy, Fredericksburg, VA 22401-4413 | 2017-11-22 |
| 1427561984 | Tidewater Physical Therapy LLC | Physical Therapist | 10518 Spotsylvania Ave Ste 100, Fredericksburg, VA 22408-2693 | 2017-11-07 |
| 1841700432 | Tidewater Physical Therapy LLC | Physical Therapist | 1441 W Main St, Salem, VA 24153-3120 | 2017-10-09 |
| 1205345444 | Tidewater Physical Therapy LLC | Physical Therapist | 154 E Little Creek Rd, Norfolk, VA 23505-2503 | 2017-09-20 |
| Street Address |
9980 BROOK RD UNIT 16 |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780931642 | Amanda W. Worley | Physical Therapist | 9980 Brook Rd, Unit 16, Glen Allen, VA 23059-6501 | 2012-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| 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 |
|---|---|---|---|---|
| 1528683968 | Lauren Gough | Physical Therapist | 9980 Brook Rd # 16a, Glen Allen, VA 23059-6501 | 2020-06-11 |
| 1649810144 | Meredith Bowden | Physical Therapist | 4900 Dominion Blvd Ste B, Glen Allen, VA 23060-6773 | 2020-01-13 |
| 1467018556 | Prathyusha Gogineni | Physical Therapist | 11442 Abbots Cross Ln, Glen Allen, VA 23059-1103 | 2019-05-14 |
| 1215404496 | Heba Momin | Physical Therapist | 5050 Willows Green Rd, Glen Allen, VA 23059-5686 | 2018-10-25 |
| 1861918674 | Samantha Lynn Dealto | Physical Therapist | 5300 Hickory Park Dr Ste 110, Glen Allen, VA 23059-2629 | 2017-08-15 |
| 1366965923 | Jessica Lauren Napoleon | Physical Therapist | 4101 Cox Rd Ste 301, Glen Allen, VA 23060-3320 | 2017-07-25 |
| 1821522665 | Tanya Virani | Physical Therapist | 11612 Olde Covington Way, Glen Allen, VA 23059-5698 | 2017-04-19 |
| 1255728929 | Juee Shah | Physical Therapist | 2916 Ridgegate Pl, Glen Allen, VA 23059-4682 | 2015-04-21 |
| 1588058390 | Courtney Jones | Physical Therapist | 5252 Scotsglen Dr, Glen Allen, VA 23059-5533 | 2015-03-19 |
| 1285973669 | Paul S Palmieri | Physical Therapist | 6208 Isleworth Dr, Glen Allen, VA 23059-5426 | 2013-02-05 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23059 |
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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.