NPIMap

Organization Active NPI

Atlantic General Hospital Corporation

Doing business as Atlantic General Health System

  • Nurse Practitioner
  • Berlin, MD
National Provider Identifier
1043038730
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ATLANTIC GENERAL HOSPITAL CORPORATION
Doing business as
Atlantic General Health System
Practice address
10231 Old Ocean City Blvd Ste 104
Berlin, MD 21811-3567
Phone
(410) 629-6863
NPI assigned
Oct 1, 2024
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ATLANTIC GENERAL HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephanie Gary
Title
SVP, Finance/Cfo of Tidalhealth
Phone
(410) 912-6059

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Primary Care Nurse Practitioner 363LP2300X NU
Wound Care Registered Nurse 163WW0000X NU

Addresses

Primary practice location

10231 Old Ocean City Blvd Ste 104
Berlin, MD 21811-3567

Mailing address

9733 Healthway Dr
Berlin, MD 21811-1156
Phone (410) 641-1100

Other names 1

  • Atlantic General Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atlantic General Hospital Corporation35 organizations share this tax ID, including this one
Part of
Atlantic General Hospital Corporation

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1043038730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9733 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111156",
            "telephone_number": "410-641-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10231 OLD OCEAN CITY BLVD STE 104",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113567",
            "telephone_number": "410-629-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC GENERAL HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC GENERAL HOSPITAL CORPORATION",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "GARY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "SVP, FINANCE/CFO OF TIDALHEALTH",
        "authorized_official_telephone_number": "410-912-6059"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic General Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlantic General Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.