Organization Active NPI

Abundant Life 180

  • Psychiatric/Mental Health Nurse Practitioner
  • Orient, OH
National Provider Identifier
1003790031
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ABUNDANT LIFE 180
Practice address
12271 Center Dr
Orient, OH 43146-9120
Phone
(220) 263-6047
NPI assigned
Aug 4, 2025
Last updated
Aug 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Authorized official

Name
Angela Ruth Corbett, CNPNPI 1801782479
Title
Psychiatric Nurse Practitioner
Phone
(220) 263-6047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

12271 Center Dr
Orient, OH 43146-9120

Mailing address

12271 Center Dr
Orient, OH 43146-9120
Phone (220) 263-6047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251017002074 OH Part B Supplier - Clinic/Group Practice 2365939717 Receives reassigned benefits from 1 practitioner
Practice locations: Orient, OH

National Provider Directory

National Provider Directory

Locations

3460 S Dixie Dr
Moraine, OH 45439
Phone (888) 570-1152

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1003790031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12271 CENTER DR",
            "city": "ORIENT",
            "state": "OH",
            "postal_code": "431469120",
            "telephone_number": "220-263-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12271 CENTER DR",
            "city": "ORIENT",
            "state": "OH",
            "postal_code": "431469120",
            "telephone_number": "220-263-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE 180",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "220-263-6047",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orient, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.