Active NPI
Robin Darlene Gottfried, CNP
- Nurse Practitioner
- Sycamore, OH
National Provider Identifier
1699167536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 17081-NP
- Practice address
- 103 N Pennington St
Sycamore, OH 44882-9408 - Phone
- (419) 927-6552
- Fax
- (419) 927-6500
- NPI assigned
- Mar 2, 2015
- Last updated
- Dec 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 17081-NP | OH | Primary |
Addresses
Primary practice location
103 N Pennington St
Sycamore, OH 44882-9408
Mailing address
885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone (419) 294-4991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rgottfried805767@direct.mercy.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
885 N Sandusky Ave
Upper Sandusky, OH 43351-1031
Phone 41929449912157
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17081-NP | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyandot Memorial Hospital | Current | Accepting new patients | |
| Wyandot Memorial Hospital | Current | Accepting new patients | |
| Wyandot Memorial Hospital | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
412 W Saffell Ave
Sycamore, OH 44882
Phone (419) 927-6552
107 Houpt Dr
Upper Sandusky, OH 43351
Phone (419) 294-5757
885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991
Interoperability endpoints
- rgottfried805767@direct.bsmhealth.org
- rgottfried805767@direct.mercy.com
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.
-
- Critical Access Hospital
- Upper Sandusky, OH
- NPI 1477554475
-
dba Wyandot Medical Providers at Carey
- Rural Health Clinic/Center
- Carey, OH
- NPI 1659014728
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
dba Wyandot Medical Providers at Sycamore
- Rural Health Clinic/Center
- Sycamore, OH
- NPI 1275033011
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Van Wert, OH
- NPI 1871650994
-
- Home Health Agency
- Findlay, OH
- NPI 1306057153
-
dba Harness Health Pharmacy
- General Acute Care Hospital
- Tiffin, OH
- NPI 1316994734
-
- Critical Access Hospital
- Upper Sandusky, OH
- NPI 1477554475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1699167536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 N SANDUSKY AVE",
"city": "UPPER SANDUSKY",
"state": "OH",
"postal_code": "433511031",
"telephone_number": "419-294-4991",
"fax_number": "419-294-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 N PENNINGTON ST",
"city": "SYCAMORE",
"state": "OH",
"postal_code": "448829408",
"telephone_number": "419-927-6552",
"fax_number": "419-927-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTFRIED",
"first_name": "ROBIN",
"middle_name": "DARLENE",
"name_prefix": "Ms.",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-02",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "17081-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rgottfried805767@direct.mercy.com",
"affiliation": "N",
"address_1": "103 N Pennington St",
"city": "Sycamore",
"state": "OH",
"country_code": "US",
"postal_code": "448829408",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sycamore, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.