Tidalhealth Primary Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIDALHEALTH PRIMARY CARE, LLC

Practice address

100 E Carroll St
Salisbury, MD 21801-5422

Phone

(410) 546-6400

NPI assigned

Mar 26, 2020

Last updated

Jul 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Pelot

Title

Chief Administrator Officer

Phone

(410) 543-7497

Specialties & licenses 2

Addresses

Other names 1

• TidalHealth Community Wellness Other name

Medicare fee-for-service enrollment

Enrolled in MD, DE2 enrollments

Enrollment records 2

Locations

Practitioners 103

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristen Renee Abbott, CRNP

  • Family Nurse Practitioner
  • Berlin, MD
  • NPI 1700597382
  Medicare reassignment Care Compare group NPD
• Zareen Asif Ahmed, MD

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1407039043
  Medicare reassignment Care Compare group NPD
• Nicole M Alu, DO

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1992779136
  Medicare reassignment Care Compare group NPD
• John A Appiott, D.O.

  • Family Medicine Physician
  • Federalsburg, MD
  • NPI 1669440681
  Medicare reassignment Care Compare group NPD
• Michael Reese Atkins, MD

  • Internal Medicine Physician
  • Crisfield, MD
  • NPI 1881651172
  Medicare reassignment Care Compare group NPD
• Neil Anjan Basumallik, MD

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1922636588
  Medicare reassignment Care Compare group NPD
• Mairen L Baunhofer, NP

  • Family Nurse Practitioner
  • Berlin, MD
  • NPI 1548419476

  DE

  Medicare reassignment Care Compare group NPD
• Jordan Pearson Braniff, FNP-C

  • Family Nurse Practitioner
  • Berlin, MD
  • NPI 1144707720
  Medicare reassignment Care Compare group NPD
• Cynthia Calixte, M.D.

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1528300100
  Medicare reassignment Care Compare group NPD
• Edwin Tatoy Castaneda, M.D.

  • Internal Medicine Physician
  • Berlin, MD
  • NPI 1063412385
  Medicare reassignment Care Compare group NPD
• Mary Cherry, CRNP

  • Family Nurse Practitioner
  • Snow Hill, MD
  • NPI 1720560493
  Medicare reassignment Care Compare group NPD
• Susanne Curry, FNP-BC

  • Family Nurse Practitioner
  • Salisbury, MD
  • NPI 1578991766
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1104453208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-912-4976",
            "fax_number": "410-912-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30265 Commerce Dr",
            "address_2": "Suite 206",
            "address_purpose": "LOCATION",
            "city": "Millsboro",
            "state": "DE",
            "postal_code": "199663595",
            "country_code": "US",
            "telephone_number": "302-732-8400",
            "fax_number": "302-934-6705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "201 Hall Hwy",
            "address_purpose": "LOCATION",
            "city": "Crisfield",
            "state": "MD",
            "postal_code": "218171237",
            "country_code": "US",
            "telephone_number": "410-968-1801",
            "fax_number": "410-968-1015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11101 Cathage Rd",
            "address_purpose": "LOCATION",
            "city": "Ocean Pines",
            "state": "MD",
            "postal_code": "218112115",
            "country_code": "US",
            "telephone_number": "410-912-6104",
            "fax_number": "410-208-1872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015454",
            "country_code": "US",
            "telephone_number": "410-912-5785",
            "fax_number": "410-912-3616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "428 W Market St",
            "address_purpose": "LOCATION",
            "city": "Snow Hill",
            "state": "MD",
            "postal_code": "218631127",
            "country_code": "US",
            "telephone_number": "410-912-4950",
            "fax_number": "410-632-2284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9950 N Main St",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218111076",
            "country_code": "US",
            "telephone_number": "410-912-6710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 10th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pocomoke City",
            "state": "MD",
            "postal_code": "218511607",
            "country_code": "US",
            "telephone_number": "410-912-4950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1639 Woodbrooke Dr",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218048502",
            "country_code": "US",
            "telephone_number": "410-912-5785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TIDALHEALTH PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "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 ADMINISTRATOR OFFICER",
        "authorized_official_telephone_number": "410-543-7497"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TidalHealth Community Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tidalhealth Peninsula Regional, Inc.
• Tidalhealth Peninsula Regional, Inc.
• Tidalhealth Peninsula Regional, Inc. (TidalHealth Specialty Pharmacy)
• Tidalhealth Peninsula Regional, Inc. (TidalHealth Crisis)
• Tidalhealth Peninsula Regional, Inc.
• Tidalhealth Primary Care, LLC
• Tidalhealth Primary Care, LLC
• Tidalhealth Primary Care, LLC
• Tidalhealth Primary Care, LLC
• Tidalhealth Primary Care, LLC

• Family Medicine Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Family Medicine Physician in Maryland

• 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 enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.