Individual provider Active NPI

Tabatha Ann Perreault, CNP

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1467943993
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022605 Issued in OH
Practice address
21 E State St
Columbus, OH 43215-4281
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
May 21, 2018
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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 APRN.CNP.022605 OH
Nurse Practitioner 363L00000X APRN.CNP.022605 OH Primary

Addresses

Primary practice location

21 E State St
Columbus, OH 43215-4281

Mailing address

801 Medical Dr Ste a
Lima, OH 45804-4030
Phone (419) 222-6622

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.022605OtherOHSTATE LICENSE

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
I20180613002348 OH Practitioner - Nurse Practitioner 9032464144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidestar Eldercare Corp -OhGroup PAC ID 9739504523, 43 clinicians

Practice addresses (Care Compare)

11230 State Route 364
Saint Marys, OH 45885-9534
Phone (574) 546-1900

199 Rd
Suite 103
Paulding, OH 45879-8776
Phone (574) 546-1900

505 Walnut St
Wapakoneta, OH 45895-1868
Phone (574) 546-1900

5351 Mitchaw Rd
Sylvania, OH 43560-9406
Phone (574) 546-1900

990 Bayley Dr
Cincinnati, OH 45233-1664
Phone (574) 546-1900

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as group
Quality
79.89
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022605OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guidestar Eldercare Corp -Oh Nurse Practitioner CurrentSince Aug 30, 2023 Accepting new patients
Lima Memorial Joint Operating Company PastSince Jan 4, 2020 Accepting new patients

Locations

990 Bayley Dr
Cincinnati, OH 45233
Phone (513) 347-5500

21 E State St
Columbus, OH 43215
Phone (574) 546-1999

4400 Easton Cmns
Ste 125
Columbus, OH 43219
Phone (855) 679-2366

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1467943993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MEDICAL DR STE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458044030",
            "telephone_number": "419-222-6622",
            "fax_number": "419-224-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154281",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "TABATHA",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022605",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN.CNP.022605",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.