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

Tidewater Physical Therapy, LLC

Organization Physical Therapist · NPI 1932648649

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

In the registry since
2017
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1490 Pantops Mountain Pl Ste 202
Charlottesville, VA 22911-4601
Phone: (434) 245-6472
Fax: (434) 245-6474
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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 number1932648649
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tasheda Broughton — Manager, Credentialing · (252) 248-3313
Other names Pantops Physical Therapy
NPI enumeratedFebruary 14, 2017
Last updated in NPPESSeptember 2, 2025
Certification dateDecember 6, 2024
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

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