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Tidewater Physical Therapy LLC

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

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

National Provider Identifier

1841700432

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Registry record

Entity type Organization (Type 2)
Legal business name Tidewater Physical Therapy LLC
Other name <Unavail>
Practice address 1441 W Main St, Salem, VA, 24153
Phone (540) 346-4328
Enumeration date Oct 9, 2017
Last updated in NPPES Dec 6, 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

Other identifiers

Identifier Type State Issuer
1457389595 Medicaid VA -
C05954 Other VA GROUP MEDICARE PTAN

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 1841700432, 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.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-12-06.