TIDALHEALTH SPECIALTY CARE, LLC (NPI# 1013532969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013532969 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Practice Address |
560 Riverside Dr Ste A206 Salisbury MD 21801-4704 |
| Mailing Address |
Po Box 2498 Salisbury MD 21802-2498 |
| Practice Telephone | 4109125640 |
| Practice Fax Number | 4109125787 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| 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 |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| TidalHealth Gastroenterology | Other Name - Individual/Organization |
| 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 |
| 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 |
| 1679198642 | Tidalhealth Specialty Care, LLC | Internal Medicine | 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 |
560 RIVERSIDE DR STE A206 |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104963990 | Sam Tellawi Md Pa | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2007-01-31 |
| 1861895955 | Judianne Keightly | Nurse Practitioner | 560 Riverside Dr Ste A206, Salisbury, MD 21801 | 2014-10-02 |
| 1255683181 | Melik Tiba | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2012-10-02 |
| 1205123700 | Gayle Patricia Jones | Nurse Practitioner | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2011-07-05 |
| 1912172149 | Pushpjeet Singh Kanwar | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801 | 2008-04-29 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625399 | Rowan Endoscopy Center, Pllc | Internal Medicine | 1809 Brenner Ave, Suite 102, Salisbury, NC 28144-2558 | 2019-05-28 |
| 1104963990 | Sam Tellawi Md Pa | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2007-01-31 |
| 1154490886 | John A Routenberg | Internal Medicine | 205 South Division Street, Salisbury, MD 21801 | 2006-11-07 |
| 1174574750 | Daulat S Haldea | Internal Medicine | 310 Mocksville Ave, Salisbury, NC 28144-3328 | 2006-05-16 |
| 1467000604 | Leigh Casper | Internal Medicine | 1809 Brenner Ave Ste 102, Salisbury, NC 28144-2567 | 2019-08-30 |
| 1598297806 | Rowan Diagnostic Clinic, Pa | Internal Medicine | 1809 Brenner Ave, Salisbury, NC 28144-2558 | 2017-03-28 |
| 1003196353 | Vineet Korrapati | Internal Medicine | 1809 Brenner Ave, Suite 102, Salisbury, NC 28144-2558 | 2011-08-18 |
| 1023240769 | Peninsula Regional Medical Center | Internal Medicine | 560 Riverside Dr, Suite A 206, Salisbury, MD 21801-4700 | 2009-08-13 |
| 1922240332 | John A Routenberg Md Pa | Internal Medicine | 205 S Division St, Salisbury, MD 21801-4930 | 2009-03-31 |
| 1912172149 | Pushpjeet Singh Kanwar | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801 | 2008-04-29 |
| Find all providers in SALISBURY | ||||
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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.