NPIMap

Organization Active NPI

Tidalhealth Specialty Care, LLC

  • Rheumatology Physician
  • Berlin, MD
National Provider Identifier
1144128059
Registry record updated Oct 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
TIDALHEALTH SPECIALTY CARE, LLC
Practice address
11107 Cathage Rd Unit 104
Berlin, MD 21811-2155
Phone
(410) 912-6933
Fax
(410) 912-6934
NPI assigned
Oct 29, 2026
Last updated
Oct 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2026

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

Authorized official

Name
Sloan Trammell
Title
Credentialing Manager
Phone
(410) 912-6989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

11107 Cathage Rd Unit 104
Berlin, MD 21811-2155

Mailing address

PO Box 825461
Philadelphia, PA 19182-5461
Phone (410) 912-6053

National Provider Directory

National Provider Directory
Tax ID family
Tidalhealth Specialty Care100 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

11107 Cathage Rd
Unit 104
Berlin, MD 21811
Phone (410) 641-0948

NPI Registry JSON

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

{
    "created_epoch": "1793232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793232000000",
    "number": "1144128059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825461",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825461",
            "telephone_number": "410-912-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 CATHAGE RD UNIT 104",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112155",
            "telephone_number": "410-912-6933",
            "fax_number": "410-912-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDALHEALTH SPECIALTY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-29",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A",
        "authorized_official_last_name": "TRAMMELL",
        "authorized_official_first_name": "SLOAN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "410-912-6989"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 29, 2026; 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.