Tidewater Mobile Medicine, PLLC
NPI 1225527351 · Family Medicine Physician · Portsmouth, VA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1225527351
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Tidewater Mobile Medicine PLLC
- Organization subpart
- Yes
- Authorized official
- Jimmy Cooper, Ceo/Owner(757) 977-9675
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Ambulatory Health Care Facilities
- Non-emergency Medical Transport (VAN)343900000X
Transportation Services
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Mailing address
Other names (DBA / former)
- Doing business as
- Authentic Self Counseling Services
- Doing business as
- Tmm Medical Group
Additional practice locations (1)
- 3001 Churchland BlvdChesapeake, VA 23321-5603Phone: (757) 977-9675Fax: (757) 483-8099
Registry dates
- Enumerated
- 2018-05-03
- Last updated
- 2022-01-21
- Certified
- 2022-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.