NPIMap

Individual provider Active NPI

Tina M Sosby

  • Family Nurse Practitioner
  • Jackson Center, OH
National Provider Identifier
1740631217
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.019633 Issued in OH
Practice address
805 E Pike St
Jackson Center, OH 45334-6001
Phone
(937) 596-0456
Fax
(937) 596-0462
NPI assigned
Jun 27, 2016
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.019633 OH Primary

Addresses

Primary practice location

805 E Pike St
Jackson Center, OH 45334-6001

Mailing address

805 E Pike St
P.O. Box 626
Jackson Center, OH 45334-6001
Phone (937) 596-0456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003000607 OH Practitioner - Nurse Practitioner 8325335565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Rutan HospitalGroup PAC ID 9032013792, 90 clinicians

Practice addresses (Care Compare)

120 W Main St
Russells Point, OH 43348-7500
Phone (937) 292-5063

205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone (937) 592-4015

805 E Pike St
Jackson Center, OH 45334-6001
Phone (937) 596-0456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.019633OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital CurrentSince Sep 19, 2016 Accepting new patients
Mary Rutan Hospital CurrentSince Sep 19, 2016 Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mary Rutan Hospital Past Accepting new patients

Locations

1134 N Main St
Ste 1100
Bellefontaine, OH 43311
Phone (937) 651-6820

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

500 N Westminster St
Waynesfield, OH 45896
Phone (419) 568-9100

Organizations & group practices 5

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 7

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1740631217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E PIKE ST",
            "address_2": "P.O. BOX 626",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453346001",
            "telephone_number": "937-596-0456",
            "fax_number": "937-596-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E PIKE ST",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453346001",
            "telephone_number": "937-596-0456",
            "fax_number": "937-596-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSBY",
        "first_name": "TINA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.019633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Center, OH

Sources for this page

Verify at the official NPI Registry.