TIDEWATER PHYSICAL THERAPY LLC (NPI# 1841700432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841700432 |
| Entity Type | Organization |
| Organization Name | TIDEWATER PHYSICAL THERAPY LLC |
| Other Organization Name | PIVOT PHYSICAL THERAPY OF VIRGINIA |
| Practice Address |
1441 W Main St Salem VA 24153-3120 |
| Mailing Address |
350 New Fidelity Ct Garner NC 27529-2665 |
| Practice Telephone | 5403464328 |
| Mailing Telephone | 9192582714 |
| Mailing Fax Number | 4106484878 |
| Enumeration Date | 2017-10-09 |
| 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 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | GROUP MEDICARE PTAN | C05954 | 01 |
| VA | 1457389595 | 05 |
| Other Name | Type Code |
|---|---|
| Pivot Physical Therapy of Virginia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386679595 | Tidewater Physical Therapy LLC | Occupational Therapist | 9980 Brook Rd, Unit 16, Glen Allen, VA 23059-6501 | 2006-07-12 |
| 1497244800 | Tidewater Physical Therapy LLC | Physical Therapist | 5629 Plank Rd Ste 107, Fredericksburg, VA 22407-7216 | 2018-05-02 |
| 1659876407 | Tidewater Physical Therapy LLC | Physical Therapist | 15331 Creativity Dr Ste 960, Culpeper, VA 22701-2502 | 2018-03-26 |
| 1558869784 | Tidewater Physical Therapy LLC | Physical Therapist | 44 Broad Street Rd, Manakin Sabot, VA 23103-2213 | 2018-01-23 |
| 1972001147 | Tidewater Physical Therapy LLC | Physical Therapist | 2925 Polo Pkwy, Midlothian, VA 23113-1453 | 2018-01-23 |
| 1588172993 | Tidewater Physical Therapy LLC | Physical Therapist | 229 Connor Dr, Charlottesville, VA 22911-5604 | 2018-01-19 |
| 1124533609 | Tidewater Physical Therapy LLC | Physical Therapist | 2400 Lakeside Drive, Suite 602f, Lynchburg, VA 24501 | 2017-12-06 |
| 1861906166 | Tidewater Physical Therapy LLC | Physical Therapist | 1149 Jefferson Davis Hwy, Fredericksburg, VA 22401-4413 | 2017-11-22 |
| 1427561984 | Tidewater Physical Therapy LLC | Physical Therapist | 10518 Spotsylvania Ave Ste 100, Fredericksburg, VA 22408-2693 | 2017-11-07 |
| 1205345444 | Tidewater Physical Therapy LLC | Physical Therapist | 154 E Little Creek Rd, Norfolk, VA 23505-2503 | 2017-09-20 |
| Street Address |
1441 W MAIN ST |
| City | SALEM |
| State | VA |
| Zip Code | 24153-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972021020 | India Shae Davidson | Physical Therapist | 1441 W Main St, Salem, VA 24153-3120 | 2017-09-08 |
| 1881206852 | Paige Thompson | Physical Medicine & Rehabilitation | 1441 W Main St, Salem, VA 24153-3120 | 2020-08-20 |
| 1871078386 | Sean Patrick Bouthilette | Physical Therapist | 1441 W Main St, Salem, VA 24153-3120 | 2018-10-01 |
| 1942791397 | Erika P. Worthley | Physical Therapist | 1441 W Main St, Salem, VA 24153-3120 | 2018-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| 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 |
|---|---|---|---|---|
| 1356953913 | Brittany Smart | Physical Therapist | 7137 236th Ave Ste 101, Salem, WI 53168-8975 | 2020-08-17 |
| 1710509229 | Joseph Peter Pepe | Physical Therapist | 35 Congress St Ste 211, Salem, MA 01970-5529 | 2020-05-07 |
| 1235796293 | Elise Miranda Princehouse | Physical Therapist | 4049 Market St Ne, Salem, OR 97301-1902 | 2019-05-24 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1386148336 | Kimberly Hunley | Physical Therapist | 4 Dunbar Ter, Salem, NH 03079-3123 | 2018-03-22 |
| 1255846309 | Chester Delfin | Physical Therapist | 515 Taggart Dr Nw Ste 150, Salem, OR 97304-4149 | 2017-12-12 |
| 1972021020 | India Shae Davidson | Physical Therapist | 1441 W Main St, Salem, VA 24153-3120 | 2017-09-08 |
| 1184141913 | Kyle Macri | Physical Therapist | 84 Highland Ave Ste 201, Salem, MA 01970-2736 | 2017-08-23 |
| 1902356892 | Heather Popp | Physical Therapist | 4 Ames St, Salem, MA 01970-2610 | 2016-10-04 |
| Find all providers in SALEM | ||||
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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.