Individual provider Active NPI

Nafisa Ibrahim, RN

  • Family Nurse Practitioner
  • Pataskala, OH
National Provider Identifier
1821323569
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024746 Issued in OH
Practice address
8910 Broad St SW
Pataskala, OH 43062-7886
Phone
(740) 927-6705
Fax
(740) 964-0036
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024746 OH Primary
Registered Nurse 163W00000X RN. 353502 OH

Addresses

Primary practice location

8910 Broad St SW
Pataskala, OH 43062-7886

Mailing address

2491 Griffin Gate LN Unit 201
Columbus, OH 43219-3919
Phone (614) 209-1268

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
I20210209001763 OH Practitioner - Nurse Practitioner 4183039936 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
First Step Recovery CenterGroup PAC ID 3375823115, 10 clinicians

Practice addresses (Care Compare)

1649 Brice Rd
Suite C
Reynoldsburg, OH 43068-2796
Phone (614) 300-5878

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN. 353502OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
First Step Recovery Center CurrentSince Oct 10, 2020 Accepting new patients
First Step Recovery Center CurrentSince Oct 10, 2020 Accepting new patients
Boulder Care Provider Group PA CurrentSince Nov 6, 2023 Accepting new patients
First Step Recovery Center Past Accepting new patients

Locations

813 Bryden Rd
Columbus, OH 43205
Phone (614) 392-7253

2628 Kull Rd
Lancaster, OH 43130
Phone (614) 300-1878

1271 Crescent Heights Rd
Ste 200
Marion, OH 43302
Phone (614) 808-3192

245 Saint James St
Marion, OH 43302
Phone (740) 341-2067

1563 Brice Rd
Reynoldsburg, OH 43068

1649 Brice Rd
Ste C
Reynoldsburg, OH 43068
Phone (614) 300-5878

1653 Brice Rd
Reynoldsburg, OH 43068
Phone (614) 300-5878

20046 Walker Rd
Ste 7
Shaker Heights, OH 44122
Phone (503) 208-5061

111 SW Naito Pkwy
Ste 200
Portland, OR 97204
Phone (503) 208-5061

Interoperability endpoints

  • Direct secure messaging: nafisa.ibrahim@620407976427524.direct.elationemr.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1821323569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2491 GRIFFIN GATE LN UNIT 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432193919",
            "telephone_number": "614-209-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 BROAD ST SW",
            "city": "PATASKALA",
            "state": "OH",
            "postal_code": "430627886",
            "telephone_number": "740-927-6705",
            "fax_number": "740-964-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "NAFISA",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024746",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN. 353502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pataskala, OH

Sources for this page

Verify at the official NPI Registry.