Individual provider Active NPI

Tarra J Waltmire, APRN, FNP-BC

  • Family Nurse Practitioner
  • Van Wert, OH
National Provider Identifier
1407108764
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0034316 Issued in OH
Practice address
111 E. Main St.
Suite 205
Van Wert, OH 45891
Phone
(419) 210-5251
Fax
(970) 238-8454
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015439A IN
Family Nurse Practitioner 363LF0000X APRN.CNP.0034316 OH Primary

Addresses

Primary practice location

111 E. Main St.
Suite 205
Van Wert, OH 45891

Mailing address

933 McKinley St
Van Wert, OH 45891-1044
Phone (419) 203-9939

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
I20241227000128 OH Practitioner - Nurse Practitioner 1355797515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio Medical University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 E Main St
Suite 205
Van Wert, OH 45891-1735
Phone (419) 210-5251

933 McKinley St
Van Wert, OH 45891-1044
Phone (419) 203-9939

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71015439AINMDFamily Nurse Practitioner
APRN.CNP.0034316OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Health & Healing LLC CurrentSince Nov 19, 2024 Accepting new patients
Nephrology Associates of Northern Indiana, Inc CurrentSince Jul 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

120 W 22nd St
Oak Brook, IL 60523

11104 Parkview Circle Dr
Ste 330
Fort Wayne, IN 46845

569 Tyler St
Gary, IN 46402
Phone (260) 885-3300

90 W 86th Ave
Merrillville, IN 46410
Phone (219) 791-1555

111 E Main St
Ste 205
Van Wert, OH 45891
Phone (419) 210-5251

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1407108764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 MCKINLEY ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911044",
            "telephone_number": "419-203-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E. MAIN ST.",
            "address_2": "SUITE 205",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "45891",
            "telephone_number": "419-210-5251",
            "fax_number": "970-238-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTMIRE",
        "first_name": "TARRA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015439A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0034316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

Verify at the official NPI Registry.