TIDALHEALTH PENINSULA REGIONAL, INC.
NPI 1306507579
Clinic/Center - Adult Mental Health in Crisfield, MD
NPI Status: Active since January 10, 2022
Contact Information
201 HALL HWY
CRISFIELD, MD
ZIP 21817
Phone: (410) 968-1200
- Organization
- Clinic/Center
- Adult Mental Health
- CLIA Number: 21D0649930
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 08-16-2027
About TIDALHEALTH PENINSULA REGIONAL, INC.
This page provides the complete NPI Profile along with additional information for Tidalhealth Peninsula Regional, Inc., a provider established in Crisfield, Maryland operating as a Clinic/center, focusing in adult mental health . The healthcare provider is registered in the NPI registry with number 1306507579 assigned on January 2022. The practitioner's primary taxonomy code is 261QM0850X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Bruce Ishmael Ritchie (Sr. Vice President/cfo)
- NPI
- 1306507579
- Provider Name
- TIDALHEALTH PENINSULA REGIONAL, INC.
- Entity Type
- Organization
- Location Address
- 201 HALL HWY CRISFIELD, MD 21817
- Location Phone
- (410) 968-1200
- Mailing Address
- PO BOX 826880 PHILADELPHIA, PA 19182
- Mailing Phone
- (410) 912-6989
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-10-2022
- Last Update Date
- 01-10-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Adult Mental Health
- Taxonomy Code
- 261QM0850X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D0649930
- Facility Type
- Hospital
- Certificate Effective Date
- August 17, 2025
- Certificate Expiration Date
- August 16, 2027
- Laboratory Director
- KIMBERLY CUESTA
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Tidalhealth Peninsula Regional, Inc. on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1306507579, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CRISFIELD, MD 21817
CRISFIELD, MD 21817
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306507579, enumerated as an "organization" on January 10, 2022.
The provider is located at 201 HALL HWY CRISFIELD, MD 21817 and the phone number is (410) 968-1200.
Clinic/Center with taxonomy code 261QM0850X and a focus in Adult Mental Health.
