Individual provider Active NPI

Tammy Marie Kaiser, CPNP

  • Pediatric Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1881965259
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN.CNP.13018 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1815
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Jan 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.285756-COA1 OH
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.13018 OH Primary

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1815

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other identifiers 1

IdentifierTypeStateIssuer
0062594MedicaidOH

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
I20120621000138 OH Practitioner - Nurse Practitioner 3678737723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Childrens Specialty Physicians IncGroup PAC ID 5496916124, 93 clinicians

Practice addresses (Care Compare)

1 Childrens PLZ
Dayton, OH 45404-1873
Phone (937) 641-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.285756-COA1OHMDRegistered Nurse
APRN.CNP.13018OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Valley Professional Corporation CurrentSince May 13, 2012 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Apr 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

280 Looney Rd
Ste 101
Piqua, OH 45356
Phone (937) 440-8687

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

31 S Stanfield Rd
Ste 201
Troy, OH 45373
Phone (937) 440-7788

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": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1881965259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "TAMMY",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.285756-COA1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.13018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.