Tidewater Physical Therapy, LLC
NPI 1467471896ActiveOrganization· Physical Therapist· Newport News, VA
Physical Therapist in Newport News, Virginia, registered in NPPES in July 2006. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing. Enrolled in Medicare as dme supplier - independently-practicing physical therapist.
Overview
| NPI | 1467471896 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 18, 2006 |
| Last updated in NPPES | Nov 25, 2024 |
| Certified by provider | Nov 25, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
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) | Enrolled DME Supplier - Independently-Practicing Physical Therapist (VA) |
|---|
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