Individual provider Active NPI

Tiffany Herron, CNP

  • General Practice Registered Nurse
  • Wapakoneta, OH
National Provider Identifier
1093553323
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
0036571 Issued in OH
Practice address
505 Walnut St
Wapakoneta, OH 45895-1868
Phone
(419) 738-0725
NPI assigned
Jul 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 0036571 OH Primary

Addresses

Primary practice location

505 Walnut St
Wapakoneta, OH 45895-1868

Mailing address

312 S Judkins Ave
Lima, OH 45805-3140
Phone (419) 231-1409

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
I20250311002926 OH Practitioner - Nurse Practitioner 0941721575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interim Healthcare Palliative Care of the Midwest IncGroup PAC ID 4688085301, 3 clinicians
Wound Med LLCGroup PAC ID 2769916915, 33 clinicians

Practice addresses (Care Compare)

Lima, OH 45806
Phone (419) 879-9394

3550 Northfield Rd
Shaker Heights, OH 44122-5249
Phone (216) 752-5600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0036571OHMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Interim Healthcare Palliative Care of the Midwest, Inc CurrentSince Oct 30, 2025 Accepting new patients
Interim Healthcare Palliative Care of the Midwest, Inc CurrentSince Oct 30, 2025 Accepting new patients
Wound Med LLC CurrentSince Jul 7, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

300 Tice Blvd
Ste 175
Woodcliff Lake, NJ 07677

3745 Shawnee Rd
Ste 108
Lima, OH 45806
Phone (419) 228-2535

300 W Wilson Bridge Rd
Ste 250
Worthington, OH 43085
Phone (614) 436-9404

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1093553323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S JUDKINS AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053140",
            "telephone_number": "419-231-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WALNUT ST",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458951868",
            "telephone_number": "419-738-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "TIFFANY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "0036571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wapakoneta, OH

Sources for this page

Verify at the official NPI Registry.