TIDALHEALTH PRIMARY CARE, LLC
NPI 1255150520
Family Medicine in Pocomoke City, MD

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

The NPI number for Tidalhealth Primary Care, LLC is 1255150520. It was assigned to this organization in the NPPES registry on October 4, 2024. The provider is also known as TidalHealth Primary Care.

Q: What is Tidalhealth Primary Care, LLC's specialty?

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

Active since October 04, 2024CLIA 21D0722290 · Microscopy

305 10TH ST STE 101, POCOMOKE CITY, MD 21851(410) 912-6167 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Tidalhealth Primary Care, Llc NPPES

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

TIDALHEALTH PRIMARY CARE, LLC (NPI 1255150520) is a healthcare organization registered as a family medicine in Pocomoke City, Maryland and active in the NPI registry since October 2024. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists William Pelot, Chief Administrator Officer, as its authorized official.

NPPES Registry Identity

NPI1255150520

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameTIDALHEALTH PRIMARY CARE, LLC

Location Address305 10TH ST STE 101Pocomoke City, MD 21851-1607

Mailing AddressPo Box 825474Philadelphia, PA 19182-5474 · (410) 912-6989 · Fax (410) 912-4972

Phone(410) 912-6167

Organization SubpartNo

Authorized OfficialWilliam PelotChief Administrator Officer · (410) 543-7497

Enumeration DateOctober 4, 2024

Last NPPES UpdateJuly 22, 2025

NPPES CertifiedJuly 22, 2025

✔ NPI 1255150520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

305 10TH ST STE 101, Pocomoke City, MD 21851

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Other Names 1

Other NameTidalhealth Primary Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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) 21D0722290

Tidalhealth Primary Care- Pocomoke · Pocomoke City, MD

Active · expires Aug 31, 2026

CLIA Number21D0722290

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorDr. Amy Johnson

Laboratory Phone(410) 912-6167

Laboratory LocationTidalhealth Primary Care- Pocomoke305 Tenth Street Suite 101, Pocomoke City, MD 21851

CLIA data matches this NPI record on: 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.

Other Providers at the Same Location NPPES 2

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

TIDALHEALTH SPECIALTY CARE, LLC

Psychiatry & Neurology (Neurology)

305 10TH ST STE 101
POCOMOKE CITY, MD 21851

Worcester County (410) 912-6167

TIDALHEALTH SPECIALTY CARE, LLC

Psychiatry & Neurology (Neurology)

305 10TH ST STE 101
POCOMOKE CITY, MD 21851

Worcester County (410) 912-6167

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 1255150520. It was assigned to this organization in the NPPES registry on October 4, 2024. The provider is also known as TidalHealth Primary Care.

Where is Tidalhealth Primary Care, LLC located?

Tidalhealth Primary Care, LLC is located at 305 10th St Ste 101, Pocomoke City, MD 21851. The listed phone number is (410) 912-6167.

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 a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D0722290) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 13 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.