TIDALHEALTH SPECIALTY CARE, LLC (NPI# 1083239933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083239933 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Practice Address |
264 Tilghman Rd Salisbury MD 21804-1921 |
| Mailing Address |
Po Box 2498 Salisbury MD 21802-2498 |
| Practice Telephone | 4107427246 |
| Practice Fax Number | 4109123610 |
| 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 | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| TidalHealth Pain Management | 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 |
| 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 |
| 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 |
264 TILGHMAN RD |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804-1921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184605461 | Conworth L Dayton-jones | Anesthesiology | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2005-11-14 |
| 1831632744 | Meredith Gwen Borzotta | Nurse Practitioner | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2016-11-24 |
| 1790914273 | Ajit Shrestha | Anesthesiology | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2009-07-06 |
| 1114077096 | Diane Marie Hernandez- Learn | Physician Assistant | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
| 1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
| 1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
| 1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
| 1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
| 1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
| 1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
| 1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
| Find all providers in zip 21804 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902364052 | Providence Pain Management Center | Anesthesiology | 201 Pine Bluff Rd, Ste 1, Salisbury, MD 21801-1401 | 2019-03-07 |
| 1952346793 | Piedmont Interventional Pain Care, Pa | Anesthesiology | 320 Jake Alexander Blvd W, Suite 103, Salisbury, NC 28147-1442 | 2006-06-17 |
| 1033178645 | Robert James Blok Sr. | Anesthesiology | 1601 Brenner Ave, Salisbury, NC 28144-2515 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861986572 | Accessible Integrative Medicine, LLC | Anesthesiology | 30 W Gude Dr Ste 375, Rockville, MD 20850-4300 | 2018-06-16 |
| 1760979116 | Advanced Pain Management Specialists, LLC | Anesthesiology | 331 Oak Manor Dr Ste 102, Glen Burnie, MD 21061-5553 | 2018-04-20 |
| 1407367055 | Consuelo Delores Fernandez | Anesthesiology | 6196 Oxon Hill Rd Ste 210, Oxon Hill, MD 20745-3137 | 2017-10-22 |
| 1598217291 | Advanced Pain Management Specialists, LLC | Anesthesiology | 10905 Fort Washington Rd Ste 405, Ft Washington, MD 20744-5807 | 2016-10-28 |
| 1104280957 | Brent Earls | Anesthesiology | 601 N Caroline St # 3062, Baltimore, MD 21287-0006 | 2016-04-07 |
| 1306213186 | Matsunaga Pain Management LLC | Anesthesiology | 8894 Stanford Blvd., Suite 104, Columbia, MD 21045-5161 | 2015-08-27 |
| 1801213863 | Jonathan Sean Woo | Anesthesiology | 22 South Greene Street, Room S11c00, Anestheisology, Baltimore, MD 21201 | 2014-03-27 |
| 1437409844 | Romana Baig | Anesthesiology | 1000 Bestgate Rd, Ste 400, Annapolis, MD 21401-3371 | 2012-09-12 |
| 1730455155 | Kim Vuong Hoang | Anesthesiology | 8455 Colesville Rd Ste 200, Silver Spring, MD 20910 | 2012-03-29 |
| 1295026342 | Anesthesia and Interventional Pain Management Center | Anesthesiology | 12821 Oak Hill Ave Ste 2, Hagerstown, MD 21742-2937 | 2011-04-25 |
| Find all providers with the same taxonomy | ||||
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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.