TIDEWATER COMPREHENSIVE REHABILITATION, PLLC (NPI# 1619172186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619172186 |
| Entity Type | Organization |
| Organization Name | TIDEWATER COMPREHENSIVE REHABILITATION, PLLC |
| Other Organization Name | TIDEWATER REHAB |
| Practice Address |
400 Gresham Dr Ste 712 Norfolk VA 23507-1901 |
| Practice Telephone | 7576228181 |
| Practice Fax Number | 7576228088 |
| Mailing Telephone | 7576228181 |
| Mailing Fax Number | 7576228088 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2007-11-01 |
| Authorized Official Name | DAVID HARRIS (ADMINISTRATOR) |
| Authorized Official Telephone | 7576228181 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Tidewater Rehab | Other Name - Individual/Organization |
| Street Address |
400 GRESHAM DR STE 712 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548269483 | Alex Olabode Williams | Internal Medicine | 400 Gresham Dr, Suite 303, Norfolk, VA 23507-1901 | 2005-07-20 |
| 1609311760 | Vrx1 LLC | Pharmacy | 400 Gresham Dr, Suite 104, Norfolk, VA 23507-1901 | 2016-12-28 |
| 1891143855 | Lisa J Ulmer | Psychologist | 400 Gresham Dr, Suite 900, Norfolk, VA 23507-1901 | 2016-06-01 |
| 1245690403 | Healthstat Onsite Clinic Chkd | Preventive Medicine | 400 Gresham Dr, Suite 406 Medical Tower, Norfolk, VA 23507-1901 | 2016-03-02 |
| 1740618412 | Bon Secours Depaul Medical Center | Internal Medicine | 400 Gresham Dr, Suite 808, Norfolk, VA 23507-1901 | 2013-10-16 |
| 1306157847 | Trisha Marie Stueber | Physician Assistant | 400 Gresham Dr, Norfolk, VA 23507-1901 | 2010-06-30 |
| 1346551736 | Ghent Internal Medicine PC | Internal Medicine | 400 Gresham Dr, Ste. 205, Norfolk, VA 23507-1901 | 2010-06-30 |
| 1568787638 | Meaghan G Dehart | Registered Nurse | 400 Gresham Dr, Suite 303, Norfolk, VA 23507-1901 | 2010-04-01 |
| 1699936112 | Sharon Murphy Finefrock | Advanced Practice Midwife | 400 Gresham Dr, Suite 811, Norfolk, VA 23507-1901 | 2008-06-18 |
| 1144480757 | Rachel E Rotenberry | Nurse Practitioner | 400 Gresham Dr, Suite 811, Norfolk, VA 23507-1901 | 2008-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598926685 | Laurie Ellen Yablon | Physical Medicine & Rehabilitation | 825 Fairfax Ave., Fairfax Hall-6th Floor Evms Physical Med&rehab, Norfolk, VA 23507-1914 | 2008-06-20 |
| 1386852028 | Charles Dillard | Physical Medicine & Rehabilitation | 400 Gresham Dr Ste 800, Norfolk, VA 23507 | 2007-05-18 |
| 1093752883 | Daniel M Wik | Physical Medicine & Rehabilitation | 110 N 37th St, Ste 103, Norfolk, NE 68701-3283 | 2006-06-01 |
| 1245237791 | Beverly Lavern Roberts-atwater | Physical Medicine & Rehabilitation | 721 Fairfax Ave, 3rd Floor, Norfolk, VA 23507-2007 | 2005-06-30 |
| 1902458813 | Amanda Votta | Physical Medicine & Rehabilitation | 1203 N 13th St, Norfolk, NE 68701-2609 | 2019-07-10 |
| 1992231039 | Amanda Moran | Physical Medicine & Rehabilitation | 721 Fairfax Ave Fl 3, Norfolk, VA 23507 | 2017-05-10 |
| 1386086312 | Lee M Hahn | Physical Medicine & Rehabilitation | 110 N 37th St, Suite 102, Norfolk, NE 68701-3283 | 2013-07-18 |
| 1972819308 | Winning Physical Medicine and Rehab Strategies, P.C. | Physical Medicine & Rehabilitation | 1500 Koenigstein Ave, Norfolk, NE 68701-3664 | 2010-08-23 |
| 1528383122 | Sun Duck Kwon | Physical Medicine & Rehabilitation | 721 Fairfax Ave, 3rd Floor, Norfolk, VA 23507-2007 | 2010-04-07 |
| 1316102577 | Pete-gaye V. Nation | Physical Medicine & Rehabilitation | 721 Fairfax Ave Fl 3, Evms Pmr Departmnet, Norfolk, VA 23507-2007 | 2008-07-26 |
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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.