Tidewater Physical Therapy, LLC
NPI 1508898354ActiveOrganization· Physical Therapist· Colonial Heights, VA
Physical Therapist in Colonial Heights, Virginia, registered in NPPES in July 2006. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1508898354 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 6, 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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