Individual provider Active NPI

Timothy W Haupricht, CNP

  • Nurse Practitioner
  • Maumee, OH
National Provider Identifier
1033546130
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-14934 Issued in OH
Practice address
1715 Indian Wood Cir Ste 266&265
Maumee, OH 43537-4055
Phone
(419) 578-8594
Fax
(855) 618-2622
NPI assigned
Oct 3, 2013
Last updated
Jul 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-14934 OH Primary

Addresses

Primary practice location

1715 Indian Wood Cir Ste 266&265
Maumee, OH 43537-4055

Mailing address

PO Box 1239
Troy, MI 48099-1239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150803002922 OH Practitioner - Nurse Practitioner 4183938293 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-14934OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Jul 13, 2015 Accepting new patients
Vpa PC CurrentSince Jul 13, 2015 Accepting new patients
Vpa PC Current Accepting new patients

Locations

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

1900 Indian Wood Cir
Ste 202B
Maumee, OH 43537
Phone (419) 578-8594

7350 Industrial Park Blvd
Mentor, OH 44060
Phone (216) 732-9480

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1033546130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 INDIAN WOOD CIR STE 266&265",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374055",
            "telephone_number": "419-578-8594",
            "fax_number": "855-618-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPRICHT",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-03",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-14934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.