Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Physical Therapy, LLC

Organization Physical Therapist · NPI 1083133268

Tidewater Physical Therapy, LLC is a Physical Therapist in Virginia Beach, Virginia. Licensed in Virginia. Registered with an NPI since 2017.

Licensed in
VA
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4624 Pembroke Blvd Ste 101
Virginia Beach, VA 23455-6450
Phone: (757) 460-3363
Fax: (757) 460-1809
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (VA)

Record details

NPI number1083133268
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pivot Physical Therapy Of Virginia; Pivot Physical Therapy Of Virginia
NPI enumeratedSeptember 19, 2017
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

Other providers in Virginia Beach