Tidewater Physical Therapy LLC
NPI 1144972159ActiveOrganization· Physical Therapist· Suffolk, VA
Physical Therapist in Suffolk, Virginia, registered in NPPES in January 2022. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1144972159 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 20, 2022 |
| Last updated in NPPES | Nov 25, 2024 |
| Certified by provider | Nov 25, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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