TIDEWATER THERAPY FOR CHILDREN, PC (NPI# 1386667400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386667400 |
| Entity Type | Organization |
| Organization Name | TIDEWATER THERAPY FOR CHILDREN, PC |
| Practice Address |
4016 Raintree Rd Suite 240 Chesapeake VA 23321-3700 |
| Practice Telephone | 7574882864 |
| Practice Fax Number | 7574884735 |
| Mailing Telephone | 7574882864 |
| Mailing Fax Number | 7574884735 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JESSICA ML DUPREE (OFFICE/INSURANCE MANAGER) |
| Authorized Official Telephone | 7574882864 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM PROVIDER # | 194322 | 01 |
| VA | OPTIMA PROVIDER # | 57242 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881814671 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Road, Suite 240, Chesapeake, VA 23321 | 2007-04-26 |
| 1174549000 | Tidewater Therapy for Children, PC | Speech-Language Pathologist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-07-14 |
| 1316051287 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-08-18 |
| 1285657874 | Tidewater Therapy for Children, PC | Occupational Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-07-25 |
| Street Address |
4016 RAINTREE RD SUITE 240 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23321-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174549000 | Tidewater Therapy for Children, PC | Speech-Language Pathologist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-07-14 |
| 1194324962 | Rebecca Schwartzman | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2020-10-22 |
| 1053960179 | Claire Allyson Laibstain | Assistant Behavior Analyst | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2019-09-11 |
| 1194221473 | Kendall Buonviri | Behavioral Analyst | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2018-04-04 |
| 1598271314 | Joi Deannia Rountree | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-15 |
| 1518472448 | Elizabeth Fortune | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-14 |
| 1710492640 | Destinee Monae Romein | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-14 |
| 1457701328 | Lara Mccarter | Speech-Language Pathologist | 4016 Raintree Rd, Suite 100 A, Chesapeake, VA 23321-3700 | 2016-06-21 |
| 1649667056 | Janet Webb | Speech-Language Pathologist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-04-23 |
| 1851782601 | Sharon Miller | Occupational Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-02-16 |
| 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 | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881814671 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Road, Suite 240, Chesapeake, VA 23321 | 2007-04-26 |
| 1962890392 | Marci Knight | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-01-08 |
| 1972892784 | Joann Croghan | Physical Therapist | 3216 Meadowbrook Ln, Chesapeake, VA 23321-5440 | 2011-04-01 |
| 1770892200 | Sofia Marie Lopez Crisostomo | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2010-10-01 |
| 1154552719 | Stacey L Haught | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2009-07-30 |
| 1366637621 | Melanie Arthur Ahlers | Physical Therapist | 733 Volvo Pkwy, Chesapeake, VA 23320-1609 | 2007-09-10 |
| 1003025040 | Michelle Lynn Higgins | Physical Therapist | 733 Volvo Pkwy, Chesapeake, VA 23320-1609 | 2007-05-22 |
| 1316051287 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334175 | Elizabeth Huff | Physical Therapist | 601 S Carlin Springs Rd Ste 505, Arlington, VA 22204-1044 | 2019-09-09 |
| 1851946503 | Courtney E Marin | Physical Therapist | 2235 Tacketts Mill Dr Bldg C, Woodbridge, VA 22192-3036 | 2019-08-08 |
| 1912475419 | Kelly Laughlin | Physical Therapist | 3544 36th Rd N, Arlington, VA 22207-4817 | 2018-11-02 |
| 1336622257 | Progressive Pediatric Therapy | Physical Therapist | 150 S. Washington St., #203, Falls Church, VA 22124 | 2018-09-07 |
| 1013413699 | Melissa Anne Casey | Physical Therapist | 778 Springsbury Rd, Berryville, VA 22611-1513 | 2018-04-03 |
| 1316443336 | Rhea Amber Whitlock | Physical Therapist | 615 East St, Blackstone, VA 23824-2231 | 2018-03-30 |
| 1821507062 | Jennifer Lewis | Physical Therapist | 6856 Richmond Highway, Alexandria, VA 22306 | 2017-09-20 |
| 1144758889 | Kristen Michelle Mcbee | Physical Therapist | 2781 Jefferson Davis Hwy, Stafford, VA 22554-8322 | 2017-05-25 |
| 1316313588 | Elizabeth Anne Brewer | Physical Therapist | 23 Curle Road, Hampton, VA 23669 | 2015-08-11 |
| 1912300377 | Kiley Coleman Gibbs | Physical Therapist | 21631 Ridgetop Cir Ste 225a, Sterling, VA 20166 | 2014-09-30 |
| Find all providers with the same taxonomy | ||||
| City | CHESAPEAKE |
| Zip Code | 23321 |
Please comment or provide details below to improve the information on TIDEWATER THERAPY FOR CHILDREN, PC.
| 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.