Tidewater Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TIDEWATER PHYSICAL THERAPY, LLC

Doing business as

Pivot Physical Therapy of Virginia

Practice address

2033 Colonial Ave SW Ste 138
Roanoke, VA 24015-3210

Phone

(540) 466-3981

Fax

(757) 739-7476

NPI assigned

Dec 14, 2017

Last updated

Nov 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tasheda Broughton, PESC

Title

Manager, Credentialing

Phone

(252) 248-3313

Specialties & licenses 1

Addresses

Other names 1

• Pivot Physical Therapy of Virginia Doing business as

Locations (25 of 33)

Practitioners 388

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Abshear

  • Physical Therapist
  • Chesapeake, VA
  • NPI 1306405048
  NPD
• Arron Achey, DPT

  • Physical Therapist
  • Chesapeake, VA
  • NPI 1891270617
  NPD
• Briana L Aiken, PT DPT

  • Physical Therapist
  • Newport News, VA
  • NPI 1982603031
  NPD
• Madison Bre Allen, PT, DPT

  • Physical Therapist
  • Chester, VA
  • NPI 1700645215
  NPD
• Amanda T Alling, DPT

  • Physical Therapist
  • Midlothian, VA
  • NPI 1700197787
  NPD
• Katherine Alombro

  • Physical Therapist
  • Newport News, VA
  • NPI 1457190191
  NPD
• Mickayla Armour, DPT

  • Physical Therapist
  • Suffolk, VA
  • NPI 1306680095
  NPD
• Dharanisri Atluri, DPT

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1447130042
  NPD
• Caroline Averette, DPT

  • Physical Therapist
  • Chesapeake, VA
  • NPI 1205690914
  NPD
• Stanley Jefferson Bailey IV, DPT

  • Physical Therapist
  • Charlottesville, VA
  • NPI 1659010247
  NPD
• Stephen K Bailey, PT, DPT, CMTPT, FMSC

  • Physical Therapist
  • Powhatan, VA
  • NPI 1679817928
  NPD
• Briana Bain

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1619589561
  NPD

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1437664356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 COLONIAL AVE SW STE 138",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153210",
            "telephone_number": "540-466-3981",
            "fax_number": "757-739-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "252-248-3313",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivot Physical Therapy of Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thriving Families Counseling, LLC
• Angela D. Thruman, COTA
• Sean Thuesen, MS, ATC
• Gary Tickle
• Tamera M Tickle, RPH
• Megan Tiffany, RN
• Jonathan Till, MD
• Linda Garbacik Till, D.D.S.
• James Tillery III, BT
• Elizabeth Tilley

• Physical Therapist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.