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TIDALHEALTH PRIMARY CARE, LLC
NPI 1104453208
Family Medicine in Salisbury, MD

Active since March 26, 2020CLIA Certified · 7 labs
100 E CARROLL ST, SALISBURY, MD 21801(410) 546-6400 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 5, 2024, Jun 15, 2020, Jun 3, 2020 and 2 more (5 updates tracked since 2020).

About Tidalhealth Primary Care, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDALHEALTH PRIMARY CARE, LLC (NPI 1104453208) is a healthcare organization registered as a family medicine in Salisbury, Maryland and active in the NPI registry since March 2020. The organization holds 7 active CLIA laboratory certificates, maintains 9 additional practice locations, and lists William Pelot, Chief Administrator Officer, as its authorized official.

NPPES Registry Identity

NPI1104453208
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTIDALHEALTH PRIMARY CARE, LLC
Location Address100 E CARROLL STSalisbury, MD 21801-5422
Mailing Address100 E Carroll StSalisbury, MD 21801-5422 · (410) 912-4976 · Fax (410) 912-4972
Phone(410) 546-6400
Organization SubpartNo
Authorized OfficialWilliam PelotChief Administrator Officer · (410) 543-7497
Enumeration DateMarch 26, 2020
Last NPPES UpdateJuly 22, 20255 updates tracked since enumeration
NPPES CertifiedJuly 22, 2025
✔ NPI 1104453208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
100 E CARROLL ST, Salisbury, MD 21801
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Other Names 1

Other NameTidalhealth Community Wellness

Secondary Practice Locations 9

Location 130265 Commerce Dr, Suite 206Millsboro, DE 19966-3595 · Phone (302) 732-8400 · Fax (302) 934-6705
Location 2201 Hall HwyCrisfield, MD 21817-1237 · Phone (410) 968-1801 · Fax (410) 968-1015
Location 311101 Cathage RdOcean Pines, MD 21811-2115 · Phone (410) 912-6104 · Fax (410) 208-1872
Location 4145 E Carroll StSalisbury, MD 21801-5454 · Phone (410) 912-5785 · Fax (410) 912-3616
Location 5428 W Market StSnow Hill, MD 21863-1127 · Phone (410) 912-4950 · Fax (410) 632-2284
Location 69950 N Main StBerlin, MD 21811-1076 · Phone (410) 912-6710
Location 7305 10th St Ste 101Pocomoke City, MD 21851-1607 · Phone (410) 912-4950
Location 81639 Woodbrooke DrSalisbury, MD 21804-8502 · Phone (410) 912-5785
Location 9100 E Carroll StSalisbury, MD 21801-5422 · Phone (410) 912-6400

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Highmark Blue Cross Blue Shield Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA 7

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 08D1000923

Tidalhealth Primary Care · Millsboro, DE
Active · expires Jun 25, 2028
CLIA Number08D1000923
Laboratory TypePhysician Office
Certificate Effective DateJune 26, 2026
Certificate Expiration DateJune 25, 2028
Laboratory DirectorDr. Hilary Haack
Laboratory Phone(302) 732-8400
Laboratory LocationTidalhealth Primary Care30265 Commerce Drive, Suite 207, Millsboro, DE 19966
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 21D1058742

Tidalhealth Primary Care - Snow Hill · Snow Hill, MD
Active · expires Mar 27, 2028
CLIA Number21D1058742
Laboratory TypePhysician Office
Certificate Effective DateMarch 28, 2026
Certificate Expiration DateMarch 27, 2028
Laboratory DirectorDr. Allison Kidney
Laboratory Phone(410) 912-4950
Laboratory LocationTidalhealth Primary Care - Snow Hill428 West Market Street, Snow Hill, MD 21863
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2180668

Tidalhealth Primary Care · Crisfield, MD
Active · expires Mar 17, 2028
CLIA Number21D2180668
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorDr. Vijay K. Karumbunathan
Laboratory Phone(410) 968-1801
Laboratory LocationTidalhealth Primary Care201 Hall Highway, Crisfield, MD 21817
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2094252

Tidalhealth Primary Care · Salisbury, MD
Active · expires Apr 13, 2027
CLIA Number21D2094252
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorElleda Ziemer
Laboratory Phone(410) 912-5785
Laboratory LocationTidalhealth Primary Care1639 Woodbrooke Drive, Salisbury, MD 21804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 21D0649930

Tidalhealth Mccready Pavilion · Crisfield, MD
Active · expires Aug 16, 2027
CLIA Number21D0649930
Laboratory TypeHospital
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorKimberly Cuesta
Laboratory Phone(410) 968-1200
Laboratory LocationTidalhealth Mccready Pavilion201 Hall Highway, Crisfield, MD 21817
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 21D2198788

Tidalhealth Primary Care · Berlin, MD
Active · expires Nov 3, 2026
CLIA Number21D2198788
Laboratory TypePhysician Office
Certificate Effective DateNovember 4, 2024
Certificate Expiration DateNovember 3, 2026
Laboratory DirectorTammy Donoway
Laboratory Phone(410) 912-6710
Laboratory LocationTidalhealth Primary Care9950 North Main Place, Berlin, MD 21811
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL DEMETRIOS COLLECTOR MD
Student in an Organized Health Care Education/Training Program
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 546-6400
TIDALHEALTH SPECIALTY CARE
Pediatrics (Neonatal-Perinatal Medicine)
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 543-7749
ALEX L MAH MD
Anesthesiology
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 543-7375
MICHELLE H GRBIC MS CCC-SLP
Speech-Language Pathologist
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 546-6400
DR. SAVANNAH FINLEY DO
Student in an Organized Health Care Education/Training Program
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 546-6400
BRENDA MARTIN CRNP
Nurse Practitioner
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 543-7531
CHARLES B SILVIA JR. MD
Internal Medicine
100 E CARROLL ST, INPATIENT SERVICES
SALISBURY, MD 21801
Wicomico County (410) 543-7536
WILLIAM C TODD MD
Emergency Medicine
100 E CARROLL ST
SALISBURY, MD 21801
Wicomico County (410) 543-7100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tidalhealth Primary Care, LLC's NPI number?

The NPI number for Tidalhealth Primary Care, LLC is 1104453208. It was assigned to this organization in the NPPES registry on March 26, 2020. The provider is also known as TidalHealth Community Wellness.

Where is Tidalhealth Primary Care, LLC located?

Tidalhealth Primary Care, LLC is located at 100 E Carroll St, Salisbury, MD 21801. The listed phone number is (410) 546-6400.

What is Tidalhealth Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Tidalhealth Primary Care, LLC hold CLIA laboratory certificates?

Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Tidalhealth Primary Care, LLC accept?

Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list Tidalhealth Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tidalhealth Primary Care, LLC was last updated on July 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.