Individual provider Active NPI

Tabitha Dawn Hofer, CNP

  • Nurse Practitioner
  • Galion, OH
National Provider Identifier
1518523695
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP.024660 Issued in OH
Practice address
270 Portland Way S
Galion, OH 44833-2362
Phone
(419) 462-4656
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP.024660 OH Primary

Addresses

Primary practice location

270 Portland Way S
Galion, OH 44833-2362

Mailing address

700 N Columbus St
Crestline, OH 44827-1455
Phone (419) 462-3485

Other practice location 1

600 Richland Mall
Ontario, OH 44906-1246
Phone (419) 462-4656

Other names 1

  • Tabitha Hendrickson Former name

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
I20190828002026 OH Practitioner - Nurse Practitioner 4183952104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Ohio Family Care Center IncGroup PAC ID 3274437082, 194 clinicians

Practice addresses (Care Compare)

2981 W 4TH St
Ontario, OH 44906-1267
Phone (419) 468-0505

600 Richland Mall
Ontario, OH 44906-1246
Phone (419) 468-0505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP.024660OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

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

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

270 Portland Way S
Galion, OH 44833
Phone (419) 468-7613

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

24 Morris Rd
Ste 2
Shelby, OH 44875
Phone (419) 289-1774

Interoperability endpoints

  • Direct secure messaging: thofer1135112@direct.osumc.edu

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1518523695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455",
            "telephone_number": "419-462-3485",
            "fax_number": "419-462-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332362",
            "telephone_number": "419-462-4656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Richland Mall",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "OH",
            "postal_code": "449061246",
            "country_code": "US",
            "telephone_number": "419-462-4656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFER",
        "first_name": "TABITHA",
        "middle_name": "DAWN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "CNP.024660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "HENDRICKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.