OrganizationActive
Tidewater Physical Therapy LLC
NPI 1144972159 · Physical Therapist · Suffolk, VA
Provider details
- NPI number
- 1144972159
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Tasheda Broughton, Manager, Credentialing(252) 248-3313
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1033 Champions Way Ste 500
Suffolk, VA 23435-3775
Phone: (757) 372-9953
Fax: (757) 372-9954
Street-level locationGet directions
Mailing address
350 New Fidelity Ct
Garner, NC 27529-2665
Registry dates
- Enumerated
- 2022-01-20
- Last updated
- 2024-11-25
- Certified
- 2024-11-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.