Individual provider Active NPI

Hailey D Henderson, NP-C

  • Primary Care Nurse Practitioner
  • Tiffin, OH
National Provider Identifier
1982346748
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.0031070 Issued in OH
Practice address
2815 Oh-100
Tiffin, OH 44883
Phone
(419) 448-9728
NPI assigned
Apr 12, 2022
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.0031070 OH Primary

Addresses

Primary practice location

2815 Oh-100
Tiffin, OH 44883

Mailing address

2815 Oh-100
Tiffin, OH 44883

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
I20220505001499 OH Practitioner - Nurse Practitioner 1254728538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2815 S State Route 100
Tiffin, OH 44883-8974
Phone (419) 448-9728

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince May 2, 2022 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince May 2, 2022 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients

Locations

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

2815 S State Route 100
Tiffin, OH 44883
Phone (419) 448-9728

Interoperability endpoints

  • Direct secure messaging: htyree20849@nomshealthcare.direct-ci.com

Organizations & group practices 3

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 2

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1982346748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 OH-100",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "44883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 OH-100",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "44883",
            "telephone_number": "419-448-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "HAILEY",
        "middle_name": "D",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.0031070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.