NPIMap

Organization Active NPI

Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Crisfield, MD
National Provider Identifier
1124604442
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
TIDALHEALTH PENINSULA REGIONAL, INC.
Practice address
McCready Health Pavilion
201 Hall Hwy
Crisfield, MD 21817-1237
Phone
(410) 543-7733
NPI assigned
Mar 18, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Bruce Ritchie
Title
Cfo Finance Vice President
Phone
(410) 543-7298

Corporate family (same tax ID) 32

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

View all 32

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Peninsula Regional Medical Center (33 organizations share this tax ID)

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
General Acute Care Hospital 282N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

McCready Health Pavilion
201 Hall Hwy
Crisfield, MD 21817-1237

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 546-6400

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
000325501MedicaidMD

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
CONNECT URL Salisbury Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 18, 2021.

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1124604442",
    "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": "410-546-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCCREADY HEALTH PAVILION",
            "address_2": "201 HALL HWY",
            "city": "CRISFIELD",
            "state": "MD",
            "postal_code": "218171237",
            "telephone_number": "410-543-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDALHEALTH PENINSULA REGIONAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "RITCHIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CFO FINANCE VICE PRESIDENT",
        "authorized_official_telephone_number": "410-543-7298"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000325501",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Salisbury",
            "affiliation": "N",
            "endpointDescription": "Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Record",
            "address_1": "McCready Health Pavilion",
            "address_2": "201 Hall Hwy",
            "city": "Crisfield",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218171237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crisfield, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.