TIDEWATER THERAPY FOR CHILDREN PC NPI 1386667400

NPI Information

  • NPI: 1386667400
  • Provider Name: TIDEWATER THERAPY FOR CHILDREN, PC
  • Classification: Physical Therapist - 2251P0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • Address: 4016 RAINTREE RD
    SUITE 240
    CHESAPEAKE, VA
    ZIP 23321
  • Phone: (757) 488-2864

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NPI Details

TIDEWATER THERAPY FOR CHILDREN, PC is a pediatrics physical therapist in Chesapeake, VA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given. TIDEWATER THERAPY FOR CHILDREN, PC NPI is 1386667400. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4016 RAINTREE RD
SUITE 240
CHESAPEAKE, VA
ZIP 23321-700
Phone: (757) 488-2864
Fax: (757) 488-4735

The provider's authorized official is Jessica Ml Dupree .
The authorized official title is Office/insurance Manager and has the following contact phone number (757) 488-2864.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12251P0200XPhysical TherapistPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1194322OTHERVIRGINIAANTHEM PROVIDER #
257242OTHERVIRGINIAOPTIMA PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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