Tidewater Physical Therapy, LLC
NPI 1942703491ActiveOrganization· Physical Therapist· Blacksburg, VA
Physical Therapist in Blacksburg, Virginia, registered in NPPES in March 2018. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1942703491 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 12, 2018 |
| Last updated in NPPES | Dec 6, 2024 |
| Certified by provider | Dec 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | VA |
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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