Organization · Type 2 NPI

Tidewater Mobile Medicine, PLLC

Family Medicine Physician · Portsmouth, VA

NPI number 1225527351 Active

Practice location

3520 High St Ste 100
Portsmouth, VA 23707-3126

Call (757) 977-9675 Map

Fax (757) 483-8099

Other practice locations

3001 Churchland Blvd, Chesapeake, VA 23321-5603 · (757) 977-9675

Specialties and licenses

Taxonomy	Code	License
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Clinical Social Worker	1041C0700X	None listed
Family Medicine Physician Primary	207Q00000X	None listed
Primary Care Clinic/Center	261QP2300X	46193 (VA)
Non-emergency Medical Transport (VAN)	343900000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3 other providers at this address

Other family medicine physician providers in Portsmouth

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NPI record

NPI: 1225527351
Entity type: Organization (Type 2)
Issued: May 3, 2018
Last updated: Jan 21, 2022
Status: Active
Subpart: Yes of Tidewater Mobile Medicine PLLC

Other names

<unavail>
Authentic Self Counseling Services · doing business as
TMM Medical Group · doing business as

Authorized official

Dr. Jimmy Cooper, DHA, FNP-C
CEO/owner
(757) 977-9675

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1225527351

Tidewater Mobile Medicine, PLLC's National Provider Identifier is 1225527351, issued on May 3, 2018. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Portsmouth, VA. The record was last updated on Jan 21, 2022.