TIDEWATER PHYSICAL THERAPY, LLC (NPI# 1790270973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790270973 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY, LLC |
| Other Organization Name | PIVOT PHYSICAL THERAPY OF VIRGINIA |
| Practice Address |
392 Garrisonville Rd Ste 208 Stafford VA 22554-1576 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 5406024277 |
| Practice Fax Number | 5406288581 |
| Mailing Telephone | 9192582714 |
| Mailing Fax Number | 4106484878 |
| Enumeration Date | 2018-06-29 |
| 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 |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Pivot Physical Therapy of Virginia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
392 GARRISONVILLE RD STE 208 |
| City | STAFFORD |
| State | VA |
| Zip Code | 22554-1576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385658 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1640 Publix Way, Stafford, VA 22554 | 2020-08-05 |
| 1700368156 | Aws Altameemi | Dentist | 392 Garrisonville Road 205, Stafford, VA 22554 | 2018-09-02 |
| 1831680214 | Radka Loucka | Counselor | 2124 Jefferson Davis Highway, Suite 202, Stafford, VA 22554 | 2018-05-22 |
| 1205383718 | Ogiawesome | Non-emergency Medical Transport (VAN) | 109 Chesterbrook Court, Stafford, VA 22554 | 2016-09-01 |
| 1184088502 | Inina Plucer-rosario | Behavioral Analyst | 12 Monument Drive, Stafford, VA 22554 | 2016-04-12 |
| 1528451218 | Insight Psychological Services, Pllc | Counselor | 11 Hope Rd., Suite 213, Stafford, VA 22554 | 2015-03-05 |
| 1194142885 | Krystal Karin Edmonds | Behavioral Analyst | 538 Apricot Street, Stafford, VA 22554 | 2014-03-20 |
| 1851715312 | Maryann Byrne | Counselor | 108 Brandice St, Stafford, VA 22554 | 2014-02-04 |
| 1164857272 | Melissa C Keylor | Counselor | 11 Hope Road, Suite 213, Stafford, VA 22554 | 2013-09-09 |
| 1255777959 | Sophia Rodrigues | Physical Therapist | 2777 Jefferson Davis Hwy, Suite 109, Performance Physical Therapy, Stafford, VA 22554 | 2013-05-21 |
| Find all providers in zip 22554 | ||||
| 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 |
|---|---|---|---|---|
| 1093352056 | Marc Chua | Physical Therapist | 10707 Corporate Dr Ste 150, Stafford, TX 77477-4092 | 2019-12-09 |
| 1164928263 | Michael Luis B Escarda | Physical Therapist | 267 Garrisonville Rd Ste 101, Stafford, VA 22554-1596 | 2018-04-05 |
| 1104354554 | Jennifer Hicks | Physical Therapist | 2777 Jefferson Davis Hwy Ste 109, Stafford, VA 22554-8323 | 2017-05-30 |
| 1699179085 | Fides Noguera Capuyan | Physical Therapist | 710 Bold Ruler Dr, Stafford, TX 77477-6355 | 2014-10-15 |
| 1255777959 | Sophia Rodrigues | Physical Therapist | 2777 Jefferson Davis Hwy, Suite 109, Performance Physical Therapy, Stafford, VA 22554 | 2013-05-21 |
| 1639425242 | Federico A Umayam II | Physical Therapist | 267 Garrisonville Rd, Suite 101, Stafford, VA 22554-1596 | 2012-08-01 |
| 1639424062 | Maria Luisa Bilocura | Physical Therapist | 12311 Glenmeadow Dr, Stafford, TX 77477-2240 | 2012-07-23 |
| 1396040184 | Julie Jenkins Mcdonald | Physical Therapist | 26 Saint Charles Ct, Stafford, VA 22556-3671 | 2011-01-25 |
| 1871750885 | Amie Katherine Williams | Physical Therapist | 450 Garrisonville Rd, 109, Stafford, VA 22554 | 2008-05-19 |
| 1518151091 | Latasha Renee' Blanton | Physical Therapist | 2777 Jefferson Davis Hwy, Suite109, Stafford, VA 22554-6219 | 2007-08-28 |
| Find all providers in STAFFORD | ||||
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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.