Tidewater Physical Therapy Associates LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TIDEWATER PHYSICAL THERAPY ASSOCIATES LLC

Practice address

6009 Amberly Dr
Bradenton, FL 34208-4545

Phone

(215) 962-9557

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Frank Fedorczyk, PT,DPT

Title

Owner

Phone

(215) 962-9557

Specialties & licenses 2

Addresses

Other names 1

• Tidewater Physical Therapy Associates LLC Other name

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1972188696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 AMBERLY DR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342084545",
            "telephone_number": "215-962-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6009 AMBERLY DR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342084545",
            "telephone_number": "215-962-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER PHYSICAL THERAPY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "FEDORCZYK",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-962-9557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tidewater Physical Therapy Associates LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cynthia L Thrasher, LCSW
• Daniel C Throneburg, N.B.C., H.I.S.
• Natasha Throop, COTA/L
• Jacqueline Heather Thurston, BSW
• Tideline Sports Performance & Rehabilitation LLC
• Tidewell Home Health Services
• Denise A Tieku
• Rachel May Tierney, RN
• James A Tiesi, M.D.
• Kathy Ann Sabrina Tiller, DDS

• Physical Therapist in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.