Individual provider Active NPI

Charlese Cordry Smithson

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1477355022
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R172855 Issued in MD
Practice address
28034 Cross Creek Dr
Salisbury, MD 21801-2495
Phone
(410) 207-6880
NPI assigned
Mar 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R172855 MD Primary

Addresses

Primary practice location

28034 Cross Creek Dr
Salisbury, MD 21801-2495

Mailing address

28034 Cross Creek Dr
Salisbury, MD 21801-2495
Phone (410) 207-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251013004159 MD Practitioner - Nurse Practitioner 3072000165 Reassigns benefits to 1 organization
I20260130003362 DE Practitioner - Nurse Practitioner 3072000165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

145 E Carroll St
Suite B102
Salisbury, MD 21801-5454
Phone (410) 912-6172

804 Snow Hill Rd
Salisbury, MD 21804-1938
Phone (410) 912-4976

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Physician Network, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Oct 1, 2025 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1477355022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28034 CROSS CREEK DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012495",
            "telephone_number": "410-207-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28034 CROSS CREEK DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012495",
            "telephone_number": "410-207-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHSON",
        "first_name": "CHARLESE",
        "middle_name": "CORDRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R172855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.