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Active NPI 1104342138 Individual Practitioner Female Practitioner

Tabetha Staten , NP

Nurse Practitioner - Gerontology • Green, OH

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Tabetha Staten, NP is a certified Nurse Practitioner - Gerontology practicing in Green, OH. With approximately 9 years of clinical experience since completing medical education in 2017, Tabetha Staten delivers high-quality medical care to the local community at 1700 BOETTLER RD STE 100.

Tabetha Staten is affiliated with Illumia Health Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

1700 Boettler Rd Ste 100

Green, OH 446857793

Telephone 3308960009
Fax 3308960032
Associated Practice Facility / Clinic
🏢 Community Health Care Inc. Facility NPI 1114902137

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Gerontology in Green, OH

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs Matches City Avg
City Avg: 9.0 Yrs
State Avg: 7.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Green, OH (529 Statewide)

Telehealth Adoption Rate
100.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Staten (9 Years) 9 Yrs
Green Specialty Average (9.0 Years) 9.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-07-02
Nurse Practitioner - Gerontology Primary Specialty

NUCC Taxonomy Code: 363LG0600X

State License OH APRN.CNP.021511

Definition to come...

Hospital & Practice Group Affiliations

Illumia Health Llc

None, Akron, OH 44333

Phone: 3305765405

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. Paulo Borges , MD

Family Medicine

NPI 1366650418

Doctor of Medicine (M.D.)

Elisabeth Gruber Dillard , LISW

Social Worker - Clinical

NPI 1407358401

Licensed Independent Social Worker

Kelsey Casano , NP

Nurse Practitioner - Primary Care

NPI 1639858913

Nurse Practitioner

Tina Hawthorne , CNP

Nurse Practitioner - Family

NPI 1871778480

Certified Nurse Practitioner

NPI 1912983743

Doctor of Osteopathic Medicine (D.O.)

Mary Akers , CNP

Nurse Practitioner - Adult Health

NPI 1942753322

Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location July 02, 2026

Registered at 1700 BOETTLER RD STE 100, GREEN, OH 446857793 (Tel: 3308960009)

📍
Updated Business Mailing Address July 02, 2026

Registered at 944 CHERRY ST E, CANAL FULTON, OH 446148669 (Tel: 3308960009)

NPI Profile Active August 22, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 22, 2017

Registered at 767 E TURKEYFOOT LAKE RD STE 3, AKRON, OH 443194128 (Tel: 3308990871)

📍
Updated Business Mailing Address August 22, 2017

Registered at 333 N SUMMIT ST FL 7, TOLEDO, OH 436042615 (Tel: 8004271902)

👤
Provider Name / Credentials Updated August 22, 2017

Recorded as TABETHA STATEN, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 22, 2017

Nurse Practitioner (License #APRN.CNP.021511 in OH)

🟢
Initial NPI Registration & Enumeration August 22, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104342138
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2017
Last Update: July 02, 2026
Sole Proprietor: No

Mailing Address

944 Cherry St E

Canal Fulton, OH 446148669

Phone: 3308960009

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.