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 1417163379

Tidewater Physical Therapy, LLC is a Physical Therapist in Smithfield, Virginia. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2
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

204 Gumwood Dr
Smithfield, VA 23430-6087
Phone: (757) 357-7762
Fax: (757) 357-7765
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1417163379
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
NPI enumeratedMay 15, 2007
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address350 New Fidelity Ct, Garner, NC 27529-2665

Other providers in Smithfield