Active NPI
Tabatha L Obert
- Contractor
- Forest Lake, MN
National Provider Identifier
1457599714
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 19, 2015.
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 115 Lake St N
Forest Lake, MN 55025-2504 - Phone
- (763) 607-8473
- NPI assigned
- Jan 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
115 Lake St N
Forest Lake, MN 55025-2504
Mailing address
115 Lake St N
Forest Lake, MN 55025-2504
Phone (763) 607-8473
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232841600000",
"number": "1457599714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 LAKE ST N",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252504",
"telephone_number": "763-607-8473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 LAKE ST N",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252504",
"telephone_number": "763-607-8473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERT",
"first_name": "TABATHA",
"middle_name": "L",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-25",
"last_updated": "2009-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.