TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1508898354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508898354 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Practice Address |
300 B Temple Lake Drive Suite 1 Colonial Heights VA 23834-2938 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 8045249036 |
| Practice Fax Number | 8045249039 |
| Mailing Telephone | 9192582714 |
| Mailing Fax Number | 4106484878 |
| Enumeration Date | 2006-07-06 |
| 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 | ANTHEM BCBS (OT) | 192947 | 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 |
| 1659887396 | Tidewater Physical Therapy, LLC | Physical Therapist | 4214 Fortuna Center Plz, Dumfries, VA 22025-1515 | 2017-12-18 |
| Street Address |
300 B TEMPLE LAKE DRIVE SUITE 1 |
| City | COLONIAL HEIGHTS |
| State | VA |
| Zip Code | 23834-2938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323040 | Latoya Harris | Social Worker | 3220 Loganwood Dr, South Chesterfield, VA 23834 | 2020-07-15 |
| 1619598653 | Jasmine Cutler | Nurse Practitioner | 445 Charles Dimmock Pkwy, Colonial Heights, VA 23834 | 2020-04-30 |
| 1942841275 | Stephanie Benedict | Technician | 330 King Fisher Way, Col. Heights, VA 23834 | 2019-10-08 |
| 1134628852 | Stacie J Lewis | Hearing Instrument Specialist | 320b Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2018-02-08 |
| 1073020194 | Colonial Heights Physicians, LLC | Emergency Medicine | 60 East Roslyn Court, Colonial Heights, VA 23834 | 2018-01-10 |
| 1639681349 | Nicholas C Vickers | Hearing Instrument Specialist | 320 B Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2017-11-03 |
| 1962935015 | Selfless Service LLC | In Home Supportive Care | 256 E Ellerslie Ave Ste C, Colonial Heights, VA 23834 | 2017-04-05 |
| 1134594864 | Dominion Aba | Early Intervention Provider Agency | 2903 Bouleavard, Colonial Heights, VA 23834 | 2015-12-07 |
| 1558743039 | Dream Care of Va LLC | Durable Medical Equipment & Medical Supplies | 130 Temple Lake Dr Ste 4, Colonial Heights, VA 23834 | 2015-06-22 |
| 1811311343 | Colonial Orthopaedics Inc | Orthopaedic Surgery | 325 Charles Dimmock Parkway, Suite 301, Colonial Heights, VA 23834 | 2014-02-04 |
| Find all providers in zip 23834 | ||||
| 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 |
|---|---|---|---|---|
| 1184964108 | Roya Kordi Mirshahi | Physical Therapist | 320 Charles Dimmock Parkway, Suite 6, Colonial Heights, VA 23834 | 2013-02-28 |
| 1992974109 | Dawn Cathers | Physical Therapist | 14701 Green Summit Pl, Colonial Heights, VA 23834-5867 | 2008-02-22 |
| 1679622385 | Allison H Wirt | Physical Therapist | 300b Temple Lake Dr, Suite 1, Colonial Heights, VA 23834-2973 | 2007-01-10 |
| 1982652830 | Christian Dale Wheeler | Physical Therapist | 16412 Jefferson Davis Hwy, Colonial Heights, VA 23834 | 2006-05-04 |
| 1316901713 | April Lovering Page | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2006-04-13 |
| 1992320410 | Gil Louis Enav | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2020-06-10 |
| 1285292862 | Alicia Blackham Johnson | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2019-05-30 |
| 1730651449 | Emily Leister | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2018-12-19 |
| 1265925069 | Zachary J. Muscato | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2018-06-07 |
| 1306336169 | Ashley Nicole Kenny | Physical Therapist | 300b Temple Lake Dr Ste 1, Colonial Heights, VA 23834-2973 | 2018-05-16 |
| Find all providers in COLONIAL HEIGHTS | ||||
| City | COLONIAL HEIGHTS |
| Zip Code | 23834 |
Please comment or provide details below to improve the information on TIDEWATER PHYSICAL THERAPY, LLC.
| 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.