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Tidewater Physical Therapy, LLC

Physical Therapist in Dumfries, VA · enumerated 2017 · authorized official Tasheda Broughton, Manager, Credentialing.

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

National Provider Identifier

1659887396

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Registry record

Entity type Organization (Type 2)
Legal business name Tidewater Physical Therapy, LLC
Other name <Unavail>
Practice address 4214 Fortuna Center Plz, Dumfries, VA, 22025
Phone (571) 402-2028
Fax (571) 888-8048
Enumeration date Dec 18, 2017
Last updated in NPPES Nov 25, 2024

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Primary

Authorized official

Name Tasheda Broughton
Title Manager, Credentialing
Phone (252) 248-3313

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

What is the NPI number for Tidewater Physical Therapy, LLC?
The NPI for Tidewater Physical Therapy, LLC is 1659887396, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Tidewater Physical Therapy, LLC?
NPPES lists Tasheda Broughton (Manager, Credentialing) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-11-25.