Individual provider Active NPI

Tobie Suzanne Newberry

  • Nurse Practitioner
  • Marietta, OH
National Provider Identifier
1598908121
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
287491 Issued in OH
Practice address
300 E 8TH St Ste 120
Marietta, OH 45750-3379
Phone
(740) 374-4273
Fax
(740) 376-5098
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 56404 WV
Nurse Practitioner 363L00000X 287491 OH Primary

Addresses

Primary practice location

300 E 8TH St Ste 120
Marietta, OH 45750-3379

Mailing address

Grosvenor Hall 055
Ohio University
Athens, OH 45701-2979
Phone (740) 593-2432

Other names 1

  • Tobie Suzanne Simmons 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
I20090618000017 OH Practitioner - Nurse Practitioner 9436208162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287491OHMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1598908121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GROSVENOR HALL 055",
            "address_2": "OHIO UNIVERSITY",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012979",
            "telephone_number": "740-593-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 8TH ST STE 120",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503379",
            "telephone_number": "740-374-4273",
            "fax_number": "740-376-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "TOBIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "56404",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "287491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOBIE",
            "last_name": "SIMMONS",
            "middle_name": "SUZANNE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.