NPIMap

Organization Active NPI

Atlantic General Hospital Corporation

Doing business as Atlantic General Health System

  • Family Medicine Physician
  • Selbyville, DE
National Provider Identifier
1407674039
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ATLANTIC GENERAL HOSPITAL CORPORATION
Doing business as
Atlantic General Health System
Practice address
37464 Lion Drive
Suite 2
Selbyville, DE 19975
Phone
(302) 564-0004
Fax
(302) 564-0005
NPI assigned
Oct 2, 2024
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ATLANTIC GENERAL HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Stephanie Gary
Title
SVP, Finance/Cfo of Tidalhealth
Phone
(410) 912-6059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

37464 Lion Drive
Suite 2
Selbyville, DE 19975

Mailing address

9733 Healthway Dr
Berlin, MD 21811-1155
Phone (410) 629-6037

Other names 1

  • Atlantic General Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atlantic General Hospital35 organizations share this tax ID, including this one
Part of
Atlantic General Hospital

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1407674039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9733 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111155",
            "telephone_number": "410-629-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37464 LION DRIVE",
            "address_2": "SUITE 2",
            "city": "SELBYVILLE",
            "state": "DE",
            "postal_code": "19975",
            "telephone_number": "302-564-0004",
            "fax_number": "302-564-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC GENERAL HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC GENERAL HOSPITAL CORPORATION",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "GARY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "SVP, FINANCE/CFO OF TIDALHEALTH",
        "authorized_official_telephone_number": "410-912-6059"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic General Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlantic General Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Selbyville, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.