Heather Renee Gibbens, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

28206311A Issued in IN

Practice address

501 E Jackson St
Brazil, IN 47834-2650

Phone

(812) 264-2765

NPI assigned

Dec 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Mobile MD LLC 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• My Mobile MD LLC

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225495716

  IN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1013628809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E JACKSON ST",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478342650",
            "telephone_number": "812-264-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E JACKSON ST",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478342650",
            "telephone_number": "812-264-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBENS",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "28206311A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynne Fowler, PHARMD
• Richard Paul Frankville, D.C.
• Jennifer Jayne Gabriel, FNP-C
• Marcy Gardner, NP
• Gary Nesty
• Elizabeth Gilbert, PHARM.D.
• Sierra Kay Girton, RD
• Miranda Anne Goodale, DPM
• Erin Jenelle Graves, MASTERS DEGREE
• David Guenther

• All providers in Brazil, IN
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.