| Tidalhealth Community Wellness | |
|
100 E Carroll St Salisbury MD 21801-5422 | |
| (410) 546-6400 | |
| Not Available |
| Full Name | Tidalhealth Community Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 100 E Carroll St, Salisbury, Maryland |
| Authorized Official Name and Position | Stephanie Gary (CFO) |
| Authorized Official Contact | 4109126059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidalhealth Community Wellness 100 E Carroll St Salisbury MD 21801-5422 Ph: (410) 912-4976 | Tidalhealth Community Wellness 100 E Carroll St Salisbury MD 21801-5422 Ph: (410) 546-6400 |
| NPI Number | 1104453208 |
|---|---|
| Provider Enumeration Date | 03/26/2020 |
| Last Update Date | 03/05/2024 |
| Medicare PECOS PAC ID | 7911320635 |
|---|---|
| Medicare Enrollment ID | O20200714000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104453208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| Provider Name | Elleda C Ziemer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497742191 PECOS PAC ID: 0345236881 Enrollment ID: I20040507001000 |
| Provider Name | Brookellen Rider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326036617 PECOS PAC ID: 6608858873 Enrollment ID: I20040603000443 |
| Provider Name | Kevin C Kearney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265407498 PECOS PAC ID: 3072562008 Enrollment ID: I20050118000337 |
| Provider Name | James B Trumble |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720042831 PECOS PAC ID: 4082626577 Enrollment ID: I20060627000346 |
| Provider Name | Vijaykumar Karumbunathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174589386 PECOS PAC ID: 6608875703 Enrollment ID: I20061219000480 |
| Provider Name | Ronald P Travitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841384625 PECOS PAC ID: 1153403621 Enrollment ID: I20080123000739 |
| Provider Name | Jeffrey Russel Scheirer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760593552 PECOS PAC ID: 3476506114 Enrollment ID: I20080718000564 |
| Provider Name | Mairen Baunhofer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548419476 PECOS PAC ID: 3476613142 Enrollment ID: I20081125000700 |
| Provider Name | Mary L Fleury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992764815 PECOS PAC ID: 1850449869 Enrollment ID: I20090430000605 |
| Provider Name | Paul R Fleury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265491286 PECOS PAC ID: 6800924614 Enrollment ID: I20100514000273 |
| Provider Name | Amy S Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245292853 PECOS PAC ID: 7315075140 Enrollment ID: I20100514000323 |
| Provider Name | Zareen A Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407039043 PECOS PAC ID: 9032306360 Enrollment ID: I20101213000119 |
| Provider Name | Michael Atkins |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881651172 PECOS PAC ID: 5890974448 Enrollment ID: I20110127000997 |
| Provider Name | Laureen Gallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740251305 PECOS PAC ID: 0547234981 Enrollment ID: I20110218000609 |
| Provider Name | Christopher Snyder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073512844 PECOS PAC ID: 9537338090 Enrollment ID: I20110818000118 |
| Provider Name | Aaron Michael Sebach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225325939 PECOS PAC ID: 5799950960 Enrollment ID: I20111216000415 |
| Provider Name | Ryan Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760826275 PECOS PAC ID: 7618155409 Enrollment ID: I20130919000112 |
| Provider Name | Susanne Curry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578991766 PECOS PAC ID: 1850520370 Enrollment ID: I20140204000115 |
| Provider Name | Stephen L Mears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265867055 PECOS PAC ID: 8224269949 Enrollment ID: I20140322000112 |
| Provider Name | Lori M Latona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457583759 PECOS PAC ID: 9234364936 Enrollment ID: I20150105000896 |
| Provider Name | Melinda Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225268931 PECOS PAC ID: 2365636768 Enrollment ID: I20150202000231 |
| Provider Name | Keesha L Holden White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750834800 PECOS PAC ID: 9032406285 Enrollment ID: I20161003000733 |
| Provider Name | Melody Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174050447 PECOS PAC ID: 8123399136 Enrollment ID: I20170919000048 |
| Provider Name | Sandar Aye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942607726 PECOS PAC ID: 9335414952 Enrollment ID: I20171009000721 |
| Provider Name | Tammy Lynn Donoway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902082233 PECOS PAC ID: 1355564667 Enrollment ID: I20171026000865 |
| Provider Name | Jo Ann Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386612844 PECOS PAC ID: 3678568979 Enrollment ID: I20171213001515 |
| Provider Name | Mark D Weisman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922073386 PECOS PAC ID: 6709929581 Enrollment ID: I20180801003123 |
| Provider Name | Jordan Pearson Braniff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144707720 PECOS PAC ID: 9830440718 Enrollment ID: I20180918000442 |
| Provider Name | Mary Cherry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720560493 PECOS PAC ID: 3870846900 Enrollment ID: I20181019000257 |
| Provider Name | Allison Kidney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588120497 PECOS PAC ID: 8921349713 Enrollment ID: I20190404000065 |
| Provider Name | Sufyan Mustafa Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356703573 PECOS PAC ID: 5597090100 Enrollment ID: I20190718000090 |
| Provider Name | Anastasiya Deem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568071462 PECOS PAC ID: 6103242789 Enrollment ID: I20200813000272 |
| Provider Name | Kunal Agarwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932497773 PECOS PAC ID: 4082846860 Enrollment ID: I20200914001821 |
| Provider Name | Rebecca Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760482657 PECOS PAC ID: 2769420736 Enrollment ID: I20201105000850 |
| Provider Name | Makondo Shimukowa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730389982 PECOS PAC ID: 6002970332 Enrollment ID: I20210203002852 |
| Provider Name | Scott A Sweeney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659372811 PECOS PAC ID: 4385678457 Enrollment ID: I20211115001160 |
| Provider Name | Geetanjali Johri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457762387 PECOS PAC ID: 1951676089 Enrollment ID: I20220110000396 |
| Provider Name | Treva Stuart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053039859 PECOS PAC ID: 1153798020 Enrollment ID: I20221105000079 |
| Provider Name | Kristen Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700597382 PECOS PAC ID: 5799143475 Enrollment ID: I20230628001768 |
| Provider Name | Natalie Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124707849 PECOS PAC ID: 5496117178 Enrollment ID: I20230811001585 |
| Provider Name | Deepa Manimegalan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568849693 PECOS PAC ID: 8123371515 Enrollment ID: I20230817003558 |
| Provider Name | Megan Tyndall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915779 PECOS PAC ID: 7315391976 Enrollment ID: I20230929003494 |
| Provider Name | Neil Basumallik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922636588 PECOS PAC ID: 6901251719 Enrollment ID: I20231016000153 |
| Provider Name | Kirsten Bowie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992492755 PECOS PAC ID: 2961859624 Enrollment ID: I20231117000777 |
| Provider Name | Jason Coleman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578633301 PECOS PAC ID: 0042508830 Enrollment ID: I20231122000053 |
Tidalhealth Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1640 Woodbrooke Dr, Salisbury, MD 21804 Phone: 410-912-5640 | |
Peninsula Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 Riverside Dr, Suite A 206, Salisbury, MD 21801 Phone: 410-912-5640 Fax: 410-912-5641 | |
Oc Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 540 Riverside Dr Ste 14, Salisbury, MD 21801 Phone: 301-801-2551 | |
Daniel E Makas Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 Riverside Dr, Ste 6, Salisbury, MD 21801 Phone: 410-677-3736 Fax: 410-677-0922 | |
Same As Above Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Pine Bluff Rd, Suite 12, Salisbury, MD 21801 Phone: 410-543-4301 | |
Amy D. Walsh, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Milford St, Suite 306, Salisbury, MD 21804 Phone: 410-677-6500 Fax: 410-677-6502 | |
Genesis Eldercare Physician Services I Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 N Salisbury Blvd, Suite 201, Salisbury, MD 21801 Phone: 410-543-1957 |