NPIMap

Organization Active NPI

Tidewater Physical Therapy LLC

Doing business as Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Franklin, VA
National Provider Identifier
1265712103
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TIDEWATER PHYSICAL THERAPY LLC
Doing business as
Pivot Physical Therapy of Virginia
Practice address
1580 Armory Dr Ste B
Franklin, VA 23851-2470
Phone
(757) 562-0990
Fax
(757) 562-0496
NPI assigned
Aug 23, 2011
Last updated
Apr 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Juana Granados
Title
Director, Credentialing
Phone
(630) 575-1980

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X VA
Clinic/Center 261Q00000X

Addresses

Primary practice location

1580 Armory Dr Ste B
Franklin, VA 23851-2470

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other names 1

  • Pivot Physical Therapy of Virginia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260408000111 VA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 6406759281 Practice locations: Franklin, VA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Tidewater Physical Therapy LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1580 Armory Dr
Ste B
Franklin, VA 23851
Phone (757) 562-0990

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1265712103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 ARMORY DR STE B",
            "city": "FRANKLIN",
            "state": "VA",
            "postal_code": "238512470",
            "telephone_number": "757-562-0990",
            "fax_number": "757-562-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivot Physical Therapy of Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.