TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1265501696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265501696 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Practice Address |
2004 Sandbridge Rd Suite 102 Virginia Beach VA 23456-4084 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 7573016316 |
| Practice Fax Number | 7573016419 |
| Mailing Telephone | 9192582714 |
| Mailing Fax Number | 4106484878 |
| Enumeration Date | 2006-11-07 |
| 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) | 247660 | 01 |
| VA | BCBS (OT) | 247663 | 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 |
| 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 |
| 1659887396 | Tidewater Physical Therapy, LLC | Physical Therapist | 4214 Fortuna Center Plz, Dumfries, VA 22025-1515 | 2017-12-18 |
| Street Address |
2004 SANDBRIDGE RD SUITE 102 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23456-4084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083950810 | Robert D. Wernick, D.d.s, P.C. | Dentist | 2004 Sandbridge Rd, Ste 100, Virginia Beach, VA 23456-4084 | 2012-12-26 |
| 1528329653 | Alexis Nicole Phaup | Dentist | 2004 Sandbridge Rd, Suite 100, Virginia Beach, VA 23456-4084 | 2012-06-05 |
| 1114234309 | Brian H Edmunds | Physical Therapist | 2004 Sandbridge Rd, Suite 102, Virginia Beach, VA 23456-4084 | 2010-09-09 |
| 1427364710 | Amanda J Meyers, Dc, Ms, PC | Chiropractor | 2004 Sandbridge Rd, Suite 103, Virginia Beach, VA 23456-4084 | 2010-08-24 |
| 1538396213 | Matthew R Ammons | Physical Therapist | 2004 Sandbridge Rd, Suite 102, Virginia Beach, VA 23456-4084 | 2009-06-19 |
| 1487787404 | Robert D Wernick Dds PC | Dentist | 2004 Sandbridge Rd, Suite 100, Virginia Beach, VA 23456 | 2007-03-13 |
| 1063543411 | Robert D Wernick | Dentist | 2004 Sandbridge Rd, Suite 100, Virginia Beach, VA 23456 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336679349 | Joelene Grandy | Contractor | 1892 Riverrock Arch, Virginia Beach, VA 23456 | 2017-06-13 |
| 1023568995 | Red Mill Pediatric Dentistry and Behl Orthodontics Pllc | Dentist | 2033 Fisher Arch, Ste 100, Virginia Beach, VA 23456 | 2016-10-04 |
| 1609235803 | Maria Teresa Olivas | Registered Nurse | 3212 Fluuanna Circle, Virginia Beach, VA 23456 | 2016-02-16 |
| 1326434747 | Catharine White Cartwright | Physician Assistant | 2501 James Madison Blvd, Virginia Beach, VA 23456 | 2015-04-13 |
| 1598153785 | Harris Teeter LLC | Pharmacy | 2105 Princess Anne Road, Suite 100, Virginia Beach, VA 23456 | 2014-12-23 |
| 1881034023 | Kimberly Ann Benson | Dentist | 2105 Princess Anne Road, Suite 108, Virginia Beach, VA 23456 | 2013-07-02 |
| 1124378450 | Phyllis A. Wilson | Psychologist | 1249 Eagle Way, Virginia Beach, VA 23456 | 2012-09-13 |
| 1033477807 | Wolfgang J. Bay | Dentist | 1625 Salem Road #101, Virginia Beach, VA 23456 | 2012-04-30 |
| 1881974475 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2232 General Booth Blvd, Virginia Beach, VA 23456 | 2011-08-26 |
| 1780988857 | Casey Snyder | Dentist | 2484 North Landing Road, Virginia Beach, VA 23456 | 2011-01-05 |
| Find all providers in zip 23456 | ||||
| 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 | 23456 |
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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.