Organization
TIDEWATER THERAPY FOR CHILDREN, PC
Active
Organization
TIDEWATER THERAPY FOR CHILDREN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA ML DUPREE BS (OFFICE/INSURANCE MANAGER)
(757) 488-2864
Entity
Organization
Contact information
Practice address
4016 RAINTREE RD, SUITE 240, CHESAPEAKE, VA 23321-3700
(757) 488-2864
(757) 488-4735
Mailing address
4016 RAINTREE RD, SUITE 240, CHESAPEAKE, VA 23321-3700
(757) 488-2864
(757) 488-4735
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194322
ANTHEM PROVIDER #
VA
01
—
57242
OPTIMA PROVIDER #
VA
Enumeration date
07/26/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up