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Tidewater Mobile Medicine, Pllc

Family Medicine Physician in Portsmouth, VA · enumerated 2018 · authorized official Jimmy Cooper, Ceo/Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1225527351

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Registry record

Entity type Organization (Type 2)
Legal business name Tidewater Mobile Medicine, Pllc
Other name <Unavail>
Parent organization Tidewater Mobile Medicine Pllc
Practice address 3520 High St Ste 100, Portsmouth, VA, 23707
Phone (757) 977-9675
Fax (757) 483-8099
Enumeration date May 3, 2018
Last updated in NPPES Jan 21, 2022

Taxonomy & classification

101YA0400X Addiction (Substance Use Disorder) Counselor Behavioral Health & Social Service Providers Secondary
1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities · License 46193 (VA) Secondary
343900000X Non-emergency Medical Transport (VAN) Transportation Services Secondary

Authorized official

Name Jimmy Cooper
Title Ceo/Owner
Phone (757) 977-9675

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Tidewater Mobile Medicine, Pllc?
NPPES lists Jimmy Cooper (Ceo/Owner) as the authorized official for this organization.
What is the NPI number for Tidewater Mobile Medicine, Pllc?
The NPI for Tidewater Mobile Medicine, Pllc is 1225527351, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-01-21.