TABETHA STATEN (NP) – Gerontology Nurse Practitioner, NPI 1104342138

Gerontology Nurse Practitioner

TABETHA STATEN (NP) is a healthcare provider. based in Akron, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. APRN.CNP.021511 (OH). The NPI Number for TABETHA STATEN (NP) is 1104342138

Main info

Female

9 Years Of Experience

Accepts Medicare Assignment

Name

TABETHA STATEN (NP)

NPI

1104342138

Phone

(330) 899-0871

Address

767 E TURKEYFOOT LAKE RD STE 3

Enumeration Date

22 August 2017

Last Update Date

22 August 2017

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3305765405

Graduation Year

2017 (9 years ago)

PAC ID

4486912706

Group Practice PAC ID

7810424306

Professional Enrollment ID

I20250807000856

Address ID

OH44333XXXXAKXXXXXXXXXX00

Telehealth

Yes

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience30

Completeness75

Years active:8State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for TABETHA STATEN (NP)

767 E TURKEYFOOT LAKE RD STE 3
AKRON, OH 443194128
Phone: (330) 899-0871
Fax: (330) 899-0873
Type: Location
North Summit Street, Saint Clair Street Historic District, Toledo, Lucas County, Ohio, 43604, United States
TOLEDO, OH 436042615
Phone: (800) 427-1902
Fax: (800) 564-5952
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20250807000856	I	Nurse Practitioner	OH	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44319)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7810424306View full group profile

Name	Specialty	State
SOUAD OMRI (FNP)	Nurse Practitioner	FL
MICHAELENA MOLLY HAYDEN (AGAC-NP)	Nurse Practitioner	OH
ZOE KEMER (APRN, FNP-C)	Nurse Practitioner	OH
ELLIE THOMAS (FNP-BC)	Nurse Practitioner	TN
SHARON T SOBECKI (NP)	Nurse Practitioner	OH
MICHAEL ANTHONY CASTRO (APRN)	Nurse Practitioner	FL
MICHELLE KRISTEN YEAGER (NP-C)	Nurse Practitioner	OH
CAMERON RACHELLE MUNAFO (CNP)	Nurse Practitioner	OH
VALERIE NORFOLK (CNP)	Nurse Practitioner	OH
MRS. MEREDITH KATELYN KANET	Nurse Practitioner	OH

Reviews

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Frequently asked questions

What number should I use to identify TABETHA STATEN (NP) for billing?

Administrative and clinical systems typically use NPI 1104342138 for TABETHA STATEN (NP).

Should I treat TABETHA STATEN (NP) as an active provider?

Patients and plans typically see TABETHA STATEN (NP) as active in the national extract.

Which specialty label fits TABETHA STATEN (NP)?

NPPES ties TABETHA STATEN (NP) to Gerontology Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.

Is TABETHA STATEN (NP) tied to Akron, Ohio?

If you are local to Akron, Ohio, TABETHA STATEN (NP) may be relevant to your search.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.