Individual provider Active NPI

Nancy A Henceroth-Gatto, D.O.

  • Family Medicine Physician
  • Grove City, OH
National Provider Identifier
1164497335
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OH34003011 Issued in OH
Practice address
4191 Kelnor Dr Ste 300
Grove City, OH 43123-3990
Phone
(614) 875-6349
Fax
(614) 875-3633
NPI assigned
Feb 21, 2006
Last updated
Sep 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OH34003011 OH Primary

Addresses

Primary practice location

4191 Kelnor Dr Ste 300
Grove City, OH 43123-3990

Mailing address

5450 Frantz Rd
Ste 250
Dublin, OH 43016-4134

Other identifiers 1

IdentifierTypeStateIssuer
0466311MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000009 OH Practitioner - Family Practice 0244221539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3011OHMDClinical Psychologist
OH34003011OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Sep 20, 2009 Accepting new patients
Ohiohealth Corporation CurrentSince Sep 20, 2009 Accepting new patients
Ohiohealth Corporation Family Medicine Current Accepting new patients
W D Henceroth DO Inc Family Medicine PastSince Jun 1, 1995 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

4191 Kelnor Dr
Ste 300
Grove City, OH 43123
Phone (614) 875-3592

Interoperability endpoints

  • Direct secure messaging: nancy.henceroth-gatto.1@15614.direct.athenahealth.com

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1164497335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD",
            "address_2": "STE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4191 KELNOR DR STE 300",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431233990",
            "telephone_number": "614-875-6349",
            "fax_number": "614-875-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENCEROTH-GATTO",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "OH34003011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0466311",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, OH

Sources for this page

Verify at the official NPI Registry.