Michael Dwayne Hibbs, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP3322152 Issued in FL

Practice address

2485 Tiny Town Rd
Clarksville, TN 37042-7219

Phone

(931) 502-2423

Fax

(931) 502-2370

NPI assigned

Oct 22, 2007

Last updated

Sep 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TN

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarksville Physician Services, LLCGroup PAC ID 0547276917, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035
• Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
• Direct secure messaging: michael.hibbs.1@1879.direct.athenahealth.com
• Direct secure messaging: michael.hibbs.1@4692.direct.athenahealth.com

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.

• Clarksville Physician Services LLC

  dba Vanderbilt Physician Services Clarksville

  • General Practice Physician
  • Clarksville, TN
  • NPI 1083657829

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Clarksville Physician Services, LLC

  dba Dover Medical Clinic

  • Rural Health Clinic/Center
  • Dover, TN
  • NPI 1992077077
  NPD (past)

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

• Clarksville Health System, LLC

  dba Tennova Healthcare-Clarksville

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794
  Care Compare affiliation
• Vanderbilt University Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1396882205
  Care Compare affiliation

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1174712541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 TINY TOWN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427219",
            "telephone_number": "931-502-2423",
            "fax_number": "931-502-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 TINY TOWN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427219",
            "telephone_number": "931-502-2423",
            "fax_number": "931-502-2370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 E Venice Ave",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342923190",
            "country_code": "US",
            "telephone_number": "941-483-9730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "MICHAEL",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3322152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.hibbs.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "18659 Tamiami Trail",
            "address_2": "Suite A",
            "city": "North Port",
            "state": "FL",
            "country_code": "US",
            "postal_code": "34287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.hibbs.1@1879.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2485 Tiny Town Rd",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370427219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Betty Ruth Hester, HS
• Marissa Hewitt, RDN
• Meghan Leigh Hewitt
• Shaundreika Heyward, MHP
• Felisia M Hibbler, NP
• Sara Hibpshman, BCBA
• James Willis Hickerson Jr., MD
• Audrey Hicks, DO
• Brittany E Hicks, BCBA
• Jennifer Hicks

• Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.