Tidewater Mobile Medicine, PLLC
NPI 1225527351ActiveOrganization· Family Medicine· Portsmouth, VA
Family Medicine in Portsmouth, Virginia, registered in NPPES in May 2018, part of Tidewater Mobile Medicine PLLC. The authorized official on file is Jimmy Cooper, DHA, FNP-C, Ceo/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1225527351 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Tidewater Mobile Medicine PLLC |
| NPI issued | May 3, 2018 |
| Last updated in NPPES | Jan 21, 2022 |
| Certified by provider | Jan 21, 2022 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (VA) |
|---|
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