NPIMap

Organization Active NPI

Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
National Provider Identifier
1245214477
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HSPTL008 Issued in DE
Legal business name
TIDALHEALTH NANTICOKE, INC
Practice address
801 Middleford Rd
Seaford, DE 19973-3636
Phone
(302) 629-6611
Fax
(302) 628-6363
NPI assigned
Dec 1, 2005
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Stephanie Gary
Title
Vice President-Finance/ Cfo
Phone
(410) 912-6059

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Radiology Clinic/Center 261QR0200X
General Acute Care Hospital 282N00000X HSPTL008 DE Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

801 Middleford Rd
Seaford, DE 19973-3636

Mailing address

801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611

Other identifiers 2

IdentifierTypeStateIssuer
000067506MedicaidDE
000067105MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071214000079 DE Part A Provider - Hospital 1355234964 Practice locations: Millsboro, DE; Seaford, DE; Laurel, DE; Georgetown, DE; Bridgeville, DE; Berlin, MD
O20090522000278 DE Part B Supplier - Hospital Department(S) 1355234964 Receives reassigned benefits from 30 practitioners
Practice locations: Seaford, DE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245214477. Details of each certification follow.

Hospital certification: CCN 080006

Legal name
TIDALHEALTH NANTICOKE INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 29, 2014
Beds
119
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1945 in DE
Enrollment address
801 Middleford Rd
Seaford, DE 19973-3636
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Tidalhealth Nanticoke, Inc.CCN 080006 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

30265 Commerce Dr
Unit 106
Millsboro, DE 19966
Phone (302) 297-2424

400 Health Services Dr
Seaford, DE 19973
Phone (302) 628-6929

701 Middleford Rd
Seaford, DE 19973
Phone (302) 628-6344

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tidalhealth, Inc Organization, Salisbury, MD Corporation, Non-profit Other Jan 1, 2020 100%
Sloan Trammell Individual W-2 Managing EmployeeManager, Insurance Credentialing Oct 1, 1997
Monica Warsaw Individual W-2 Managing EmployeeDirector, HB Patient Accounts Jul 3, 2021
Benny Stover Individual Corporate OfficerSr VP Finance/Cfo Jan 5, 2026

Practitioners & affiliated clinicians

Practitioners 67

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.

View all 67

Affiliated clinicians 638

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 638

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1245214477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733636",
            "telephone_number": "302-629-6611",
            "fax_number": "302-628-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733636",
            "telephone_number": "302-629-6611",
            "fax_number": "302-628-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDALHEALTH NANTICOKE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "GARY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "VICE PRESIDENT-FINANCE/ CFO",
        "authorized_official_telephone_number": "410-912-6059"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DE",
            "license": "HSPTL008",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000067506",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000067105",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

Verify at the official NPI Registry.