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TIDALHEALTH PHYSICIAN NETWORK, INC.
NPI 1871306191
Family Medicine in Federalsburg, MD

Active since January 30, 2025
3304 HAYMAN DR, FEDERALSBURG, MD 21632(410) 754-2400 Get Directions Write a Review

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

About Tidalhealth Physician Network, Inc. NPPES

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

TIDALHEALTH PHYSICIAN NETWORK, INC. (NPI 1871306191) is a healthcare organization registered as a family medicine in Federalsburg, Maryland and active in the NPI registry since January 2025. The organization lists William Pelot, Chief Administrator Officer, as its authorized official.

NPPES Registry Identity

NPI1871306191
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTIDALHEALTH PHYSICIAN NETWORK, INC.
Location Address3304 HAYMAN DRFederalsburg, MD 21632-2626
Mailing AddressPo Box 824327Philadelphia, PA 19182-4327 · (410) 912-6989
Phone(410) 754-2400
Organization SubpartNo
Authorized OfficialWilliam PelotChief Administrator Officer · (410) 543-7497
Enumeration DateJanuary 30, 2025
Last NPPES UpdateJuly 22, 2025
NPPES CertifiedJuly 22, 2025
✔ NPI 1871306191 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.
3304 HAYMAN DR, Federalsburg, MD 21632
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Other Names 1

Other NameTidalhealth Federalsburg

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

Other Providers at the Same Location NPPES 3

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

JENNIFER BEARE KETTERMAN FNP-BC
Nurse Practitioner
3304 HAYMAN DR
FEDERALSBURG, MD 21632
Caroline County (410) 754-2440
MRS. TIARRA JONES-BBOSA CRNP
Nurse Practitioner (Family)
3304 HAYMAN DR
FEDERALSBURG, MD 21632
Caroline County (410) 754-2440
JOHN A APPIOTT D.O.
Family Medicine
3304 HAYMAN DR
FEDERALSBURG, MD 21632
Caroline County (410) 754-2440

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 Physician Network, Inc.'s NPI number?

The NPI number for Tidalhealth Physician Network, Inc. is 1871306191. It was assigned to this organization in the NPPES registry on January 30, 2025. The provider is also known as TidalHealth Federalsburg.

Where is Tidalhealth Physician Network, Inc. located?

Tidalhealth Physician Network, Inc. is located at 3304 Hayman Dr, Federalsburg, MD 21632. The listed phone number is (410) 754-2400.

What is Tidalhealth Physician Network, Inc.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Tidalhealth Physician Network, Inc. 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.