Johannah Marie McKibben, RN, BSN, FNP, MSN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A186196 Issued in NE

Practice address

320 Ebaugh St
Glenwood, IA 51534-1811

Phone

(712) 624-9185

Fax

(712) 396-4180

NPI assigned

Jun 19, 2025

Sex

Female

Sole proprietor

No

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 IA

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

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.

• Physicians Clinic Inc

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156

  IA, Nurse Practitioner

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jennie Edmundson Memorial Hospital

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  Care Compare affiliation

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1104713437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EBAUGH ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341811",
            "telephone_number": "712-624-9185",
            "fax_number": "712-396-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBEN",
        "first_name": "JOHANNAH",
        "middle_name": "MARIE",
        "credential": "RN, BSN, FNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "A186196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Autumn Leick, PHARMD
• Life Revive Counseling, LLC
• Robert Franklin Lothrop, DDS
• Julie L Lynes, MHR
• Margramon P C
• Amber Miller, R.PH.
• Mills County YMCA Special Olympics/Adaptive Program
• Timothy James Morgan, M.D.
• Perrin Musselman
• Bang Tu Nguyen, MD

• Nurse Practitioner in Glenwood, IA
• Providers in Glenwood, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.