Tidal Therapy Solutions Llc is a medicare enrolled "Clinic/center - Multi-specialty" provider in Holly Ridge, North Carolina. Their current practice location is
376 Frisco Way, Holly Ridge, North Carolina. You can reach out to their office (for appointments etc.) via phone at
(910) 290-1534.
Tidal Therapy Solutions Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Tidal Therapy Solutions Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1851010698.
Healthcare Provider's Profile
| Full Name | Tidal Therapy Solutions Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 376 Frisco Way, Holly Ridge, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1851010698
- Provider Enumeration Date: 08/24/2022
- Last Update Date: 01/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 6800337718
- Enrollment ID: O20240919000150
Medical Identifiers
Medical identifiers for Tidal Therapy Solutions Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1851010698 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Tidal Therapy Solutions Llc acts as a billing entity for following providers:
| Provider Name | Daniele Marie Mclean |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1932625563
PECOS PAC ID: 0941538052
Enrollment ID: I20190828001292 |
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| Provider Name | Laura B Futrell |
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| Provider Type | Practitioner - Occupational Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1790126514
PECOS PAC ID: 9830596428
Enrollment ID: I20210923003819 |
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| Provider Name | Elizabeth K Johanson |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1194383919
PECOS PAC ID: 6608223888
Enrollment ID: I20231109000945 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tidal Therapy Solutions Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Tidal Therapy Solutions Llc
376 Frisco Way,
Holly Ridge, NC 28445-4202
Ph: () - | Tidal Therapy Solutions Llc
376 Frisco Way,
Holly Ridge, NC 28445-4202
Ph: (910) 290-1534 |
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