NPIMap

Organization Active NPI

Tidalhealth Specialty Care, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Salisbury, MD
National Provider Identifier
1083239933
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
TIDALHEALTH SPECIALTY CARE, LLC
Practice address
264 Tilghman Rd
Salisbury, MD 21804-1921
Phone
(410) 742-7246
Fax
(410) 912-3610
NPI assigned
Jun 16, 2020
Organization subpart
Yes
Parent organization
TIDALHEALTH SPECIALTY CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
William Pelot
Title
Chief Administrative Officer
Phone
(410) 543-7497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

264 Tilghman Rd
Salisbury, MD 21804-1921

Mailing address

PO Box 2498
Salisbury, MD 21802-2498

Other practice location 1

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 912-6400

Other practice location 2

804 Snow Hill Rd
Salisbury, MD 21804-1938
Phone (410) 742-7246

Other names 1

  • TidalHealth Pain Management Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2139957Tidalhealth Pain Management264 Tilghman Road, Salisbury, MD 21804Certificate of waiverNov 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tidalhealth Specialty Care98 organizations share this tax ID, including this one
Part of
Tidalhealth Specialty Care

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1083239933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2498",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218022498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 TILGHMAN RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041921",
            "telephone_number": "410-742-7246",
            "fax_number": "410-912-3610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015422",
            "country_code": "US",
            "telephone_number": "410-912-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "804 Snow Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218041938",
            "country_code": "US",
            "telephone_number": "410-742-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TIDALHEALTH SPECIALTY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIDALHEALTH SPECIALTY CARE, LLC",
        "enumeration_date": "2020-06-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "PELOT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "410-543-7497"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TidalHealth Pain Management",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TidalHealth Pain Management",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.