| Heather C Vaughan, PT, DPT | |
|
14302 Winterview Pkwy, Midlothian, VA 23113-4386 | |
| (804) 601-6010 | |
| (804) 802-5603 |
| Full Name | Heather C Vaughan |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 14302 Winterview Pkwy, Midlothian, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619255916 | NPI | - | NPPES |
| 1616255916 | Other | VA | MEDICAID QMB |
| C05954 | Other | VA | GROUP MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2305207012 (Virginia) | Primary |
| Provider Name | Tidewater Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1457389595 PECOS PAC ID: 6406759281 Enrollment ID: O20041019001029 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather C Vaughan, PT, DPT Po Box 412307, Boston, MA 02241-2307 Ph: (914) 294-4050 | Heather C Vaughan, PT, DPT 14302 Winterview Pkwy, Midlothian, VA 23113-4386 Ph: (804) 601-6010 |
Kathryn Marie Logsdon, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2900 Calcutt Drive, Midlothian, VA 23113 Phone: 804-201-5175 | |
Lori H Atkinson, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11621 Robious Rd, Midlothian, VA 23113 Phone: 804-794-7587 Fax: 804-794-4560 | |
Rachel Rand Smith, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 611 Watkins Centre Pkwy Ste 300, Midlothian, VA 23114 Phone: 804-325-8822 Fax: 804-794-3986 | |
Michael Blake, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 13801 St Francis Blvd Ste 200, Midlothian, VA 23114 Phone: 804-320-4064 | |
Caitlin Wynings, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 13801 St Francis Blvd Ste 200, Midlothian, VA 23114 Phone: 804-915-1910 | |
Kasey Henderson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 108 Walton Park Ln, Midlothian, VA 23114 Phone: 804-560-9575 Fax: 804-560-9557 | |
Angela Diverdi-payne, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13900 Hull Street Rd, Midlothian, VA 23112 Phone: 804-639-8788 |