Individual provider Active NPI

Tabatha Jean Barber, D.O.

  • Gynecology Physician
  • Spring Lake, MI
National Provider Identifier
1336369701
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
5101016413 Issued in MI
Practice address
18008 Woodland TRL
Spring Lake, MI 49456-2826
Phone
(616) 502-1484
Fax
(866) 651-5153
NPI assigned
Apr 26, 2007
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 5101016413 MI Primary

Addresses

Primary practice location

18008 Woodland TRL
Spring Lake, MI 49456-2826

Mailing address

18008 Woodland TRL
Spring Lake, MI 49456-2826
Phone (616) 502-1484

Other names 1

  • Tabatha Jean Pefley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090928000338 MI Practitioner - Obstetrics/Gynecology 8628124922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016413MIMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privamd Physicians PLLC Obstetrics & Gynecology CurrentSince Jan 27, 2020 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

16986 Robbins Rd
Ste 180
Grand Haven, MI 49417
Phone (616) 213-0253

Organizations & group practices 2

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1336369701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18008 WOODLAND TRL",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562826",
            "telephone_number": "616-502-1484",
            "fax_number": "866-651-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18008 WOODLAND TRL",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562826",
            "telephone_number": "616-502-1484",
            "fax_number": "866-651-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBER",
        "first_name": "TABATHA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "5101016413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABATHA",
            "last_name": "PEFLEY",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Lake, MI

Sources for this page

Verify at the official NPI Registry.