TIDALHEALTH SPECIALTY CARE, LLC (NPI# 1679198642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679198642 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Practice Address |
100 E Carroll St Salisbury MD 21801-5422 |
| Mailing Address |
Po Box 2498 Salisbury MD 21802-2498 |
| Practice Telephone | 4107491282 |
| Practice Fax Number | 4107497821 |
| Mailing Telephone | 4107491282 |
| Mailing Fax Number | 4107497821 |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |
| Authorized Official Name | KARIN DIBARI (PRESIDENT) |
| Authorized Official Telephone | 6035772799 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| TidalHealth Oncology & Hematology | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11105 Cathage Rd, Ocean Pines, MD 218112131 | 4109124934 | 4109125934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992320840 | Tidalhealth Specialty Care, LLC | Internal Medicine | 560 Riverside Dr Ste A106, Salisbury, MD 21801-4702 | 2020-06-16 |
| 1245855196 | Tidalhealth Specialty Care, LLC | Internal Medicine | 1415 S Division St Ste A, Salisbury, MD 21804-7291 | 2020-06-16 |
| 1487279337 | Tidalhealth Specialty Care, LLC | Neurological Surgery | 1630 Woodbrooke Dr, Salisbury, MD 21804-8501 | 2020-06-16 |
| 1952926891 | Tidalhealth Specialty Care, LLC | Pediatrics | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-16 |
| 1013532969 | Tidalhealth Specialty Care, LLC | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2020-06-16 |
| 1053936906 | Tidalhealth Specialty Care, LLC | Internal Medicine | 314 Franklin Ave Ste 301, Berlin, MD 21811-1238 | 2020-06-16 |
| 1083239933 | Tidalhealth Specialty Care, LLC | Anesthesiology | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2020-06-16 |
| 1306461256 | Tidalhealth Specialty Care, LLC | Psychiatry & Neurology | 1630 Woodbrooke Dr, Salisbury, MD 21804-8501 | 2020-06-16 |
| 1962027094 | Tidalhealth Specialty Care, LLC | Clinic/Center | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-15 |
| 1124643184 | Tidalhealth Specialty Care, LLC | Internal Medicine | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-15 |
| Street Address |
100 E CARROLL ST |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-5422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699778811 | Heidi Elizabeth Callahan | Physician Assistant | 100 E Carroll St, # 400, Salisbury, MD 21801-5422 | 2005-05-23 |
| 1649870916 | Katelyn Marie Mcwilliams | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1356941637 | Kayla Ann Holliday | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1093315376 | Amanda Strayer | Physical Medicine & Rehabilitation | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-27 |
| 1366049876 | Fahad Nayim Md LLC | Skilled Nursing Facility | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-07 |
| 1013514157 | Michelle H Grbic | Speech-Language Pathologist | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-10-01 |
| 1568071462 | Anastasiya Deem | Nurse Practitioner | 100 E Carroll St, Salisbury, MD 21801-5493 | 2020-07-27 |
| 1336766021 | Myra Ngambo Njapau-dove | Nurse Anesthetist, Certified Registered | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-29 |
| 1588280655 | Ashton Renee Hyde | Nurse Anesthetist, Certified Registered | 100 E Carroll St, Salisbury, MD 21801-5493 | 2020-06-24 |
| 1952926891 | Tidalhealth Specialty Care, LLC | Pediatrics | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
| 1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
| 1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
| 1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
| 1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
| 1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
| 1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
| Find all providers in zip 21801 | ||||
| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891154100 | Frederick Health Hospital Inc | Clinic/Center | 1562 Opossumtown Pike Ste 101, Frederick, MD 21702-4337 | 2016-02-15 |
| 1548496573 | Alexandra Dos Santos Zimmer | Clinic/Center | 10 Center Dr 10 12n226, Bethesda, MD 20892-0001 | 2009-06-04 |
| 1386811628 | Bay Hematology Oncology Pa | Clinic/Center | 8221 Teal Dr Ste 301, Easton, MD 21601-7215 | 2008-05-15 |
| 1164590394 | Stanley D. Walker, Md, LLC | Clinic/Center | 3333 N Calvert St Ste 107, Baltimore, MD 21218-6503 | 2006-12-04 |
| 1669911293 | Bay Hematology Oncology, P.a. | Clinic/Center | 2977 4h Park Rd, Suite 102, Centreville, MD 21617-2232 | 2017-02-15 |
| 1710335187 | Physicians Rx Pharmacies | Clinic/Center | 7525 Greenway Center Drive, Suite 202, Greenbelt, MD 20770 | 2016-05-26 |
| 1710283569 | Shore Health System, Inc | Clinic/Center | 509 Idlewild Ave, Easton, MD 21601-3889 | 2011-01-26 |
| 1871788430 | Oral Medicine Consultants | Clinic/Center | 650 W Baltimore St, Room 7251, Baltimore, MD 21201-1510 | 2007-09-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.