Active NPI
William G Tabbert, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Marion, OH
National Provider Identifier
1770587404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 2025
- Practice address
- 1125 Ellen Kay Dr
Ste E
Marion, OH 43302-6358 - Phone
- (740) 387-2274
- Fax
- (740) 382-0600
- NPI assigned
- Jun 10, 2005
- Reactivated
- Mar 21, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 2025 | OH | Primary |
Addresses
Primary practice location
1125 Ellen Kay Dr
Ste E
Marion, OH 43302-6358
Mailing address
1125 Ellen Kay Dr
Ste E
Marion, OH 43302-6358
Phone (740) 387-2274
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000118247 | Other | OH | ANTHEM BLUE CROSS |
| 0464831 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025 | OH | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759881600000",
"number": "1770587404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 ELLEN KAY DR",
"address_2": "STE E",
"city": "MARION",
"state": "OH",
"postal_code": "433026358",
"telephone_number": "740-387-2274",
"fax_number": "740-382-0600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 ELLEN KAY DR",
"address_2": "STE E",
"city": "MARION",
"state": "OH",
"postal_code": "433026358",
"telephone_number": "740-387-2274",
"fax_number": "740-382-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABBERT",
"first_name": "WILLIAM",
"middle_name": "G",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2025-10-08",
"certification_date": "2025-10-08",
"deactivation_date": "2006-03-16",
"reactivation_date": "2006-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OH",
"license": "2025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000118247",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0464831",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.