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)
Tidewater Mobile Medicine, PLLC is a Family Medicine Physician organization in Portsmouth, VA (NPI 1225527351).
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
Frequently asked questions
- What is Tidewater Mobile Medicine, PLLC's NPI number?
- Tidewater Mobile Medicine, PLLC's National Provider Identifier (NPI) is 1225527351, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tidewater Mobile Medicine, PLLC?
- Tidewater Mobile Medicine, PLLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Tidewater Mobile Medicine, PLLC located?
- Tidewater Mobile Medicine, PLLC's practice location on file with NPPES is 3520 High St Ste 100, Portsmouth, VA 23707-3126.
- What is Tidewater Mobile Medicine, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Tidewater Mobile Medicine, PLLC is (757) 977-9675.
- Does Tidewater Mobile Medicine, PLLC accept Medicare?
- Tidewater Mobile Medicine, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Tidewater Mobile Medicine, PLLC?
- The authorized official listed on Tidewater Mobile Medicine, PLLC's NPPES record is Jimmy Cooper, Ceo/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tidewater Mobile Medicine, PLLC's NPI active?
- Yes — Tidewater Mobile Medicine, PLLC's NPI (1225527351) is active in the NPPES registry as of the last update on 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.