TIDEWATER PHYSICAL THERAPY, LLC – Physical Therapist, NPI 1508898354

TIDEWATER PHYSICAL THERAPY, LLC is a healthcare provider. based in Oak brook, Illinois. specializing in Physical Therapist. The NPI Number for TIDEWATER PHYSICAL THERAPY, LLC is 1508898354

Main info

Organization
Name
TIDEWATER PHYSICAL THERAPY, LLC
NPI
1508898354
Phone
(252) 248-3313
Address
2122 YORK RD STE 300
Authorized Official
TASHEDA BROUGHTON MANAGER, CREDENTIALING PESC
Enumeration Date
6 July 2006
Last Update Date
25 November 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:19State licenses:0Digital endpointsOther names

Loading map...

Provider Addresses for TIDEWATER PHYSICAL THERAPY, LLC

  • 2122 YORK RD STE 300

    OAK BROOK, IL 605231925

    Phone: (252) 248-3313

    Fax: (410) 648-4878

    Type: Mailing

  • New Fidelity Court, Garner, Wake County, North Carolina, 275, United States

    GARNER, NC 275292665

    Phone: (919) 258-2714

    Fax: (410) 648-4878

    Type: Mailing

  • Temple Lake Drive, Colonial Heights, Virginia, 23804, United States

    SUITE 1

    COLONIAL HEIGHTS, VA 238342938

    Phone: (804) 524-9036

    Fax: (804) 524-9039

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60523)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up TIDEWATER PHYSICAL THERAPY, LLC by NPI?
Use NPI 1508898354 when you need to reference TIDEWATER PHYSICAL THERAPY, LLC in forms, claims, or directories.
Is TIDEWATER PHYSICAL THERAPY, LLC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does TIDEWATER PHYSICAL THERAPY, LLC work in?
You can think of TIDEWATER PHYSICAL THERAPY, LLC as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Does TIDEWATER PHYSICAL THERAPY, LLC practice in Illinois?
You will see Oak Brook, Illinois on file for TIDEWATER PHYSICAL THERAPY, LLC alongside any extra practice locations.
Is TIDEWATER PHYSICAL THERAPY, LLC a real provider?
This page reflects official NPPES data for NPI 1508898354. Always confirm identity and privileges with the practice and licensing boards.

Similar Providers

ROBERT B DIRENFELD (DPT)

Physical Therapist
PO BOX 31630
NPI: 1962404293

AMIRA EL-DABH RANNEY (P.T.)

Physical Therapist
Southside Avenue, South Slope, Asheville, Buncombe County, North Carolina, 28802, United States
NPI: 1992701023
7855 S Emerson Ave
NPI: 1780681395

MELANIE A MCDONALD (MPT)

Physical Therapist
1834, West Canyon Way, Ocotillo Lakes, Chandler, Maricopa County, Arizona, 85248, United States
NPI: 1144228065

MICHAEL W MCMURRAY (PT)

Physical Therapist
PO BOX 9007
NPI: 1831199652
1000 N Preston Rd Ste 50
NPI: 1801898671

Unknown Individual

Physical Therapist
625, Enterprise Drive, Oak Brook, DuPage County, Illinois, 60523, United States
NPI: 1710979398
844 WASHINGTON RD
NPI: 1518951995

Athletico Physical Therapy

Rehabilitation Clinic/Center
600 OAKMONT LN STE 600C
NPI: 1821085028