Individual provider Active NPI

George Kent Kibler, MD

  • Family Medicine Physician
  • Lone Pine, CA
National Provider Identifier
1184657637
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C37172 Issued in CA
Practice address
501 E. Locust Street
Lone Pine, CA 93545-1009
Phone
(760) 876-5501
Fax
(760) 876-4388
NPI assigned
Jul 8, 2006
Last updated
Apr 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C37172 CA Primary

Addresses

Primary practice location

501 E. Locust Street
Lone Pine, CA 93545-1009

Mailing address

P.O. Box 1009
Lone Pine, CA 93545-1009
Phone (760) 876-5501

Other identifiers 9

IdentifierTypeStateIssuer
C37172OtherCALICENSE
002086560MedicaidNV
0205422OtherWAWA WORKERS COMP
GR0021672MedicaidCA
RHM53941FMedicaidCA
00C371720OtherCABLUE SHIELD
00C371720OtherCABLUE CROSS
770051426001OtherCATRICARE
183283900OtherCAWORKERS COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081213000287 CA Practitioner - Emergency MedicinePractitioner - General PracticePractitioner - Family Practice 0840101267 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Surprise Valley Health Care District CurrentSince Jun 24, 2015 Accepting new patients
Surprise Valley Health Care District CurrentSince Jun 24, 2015 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/survalh-86281d9a

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1184657637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1009",
            "city": "LONE PINE",
            "state": "CA",
            "postal_code": "935451009",
            "telephone_number": "760-876-5501",
            "fax_number": "760-876-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E. LOCUST STREET",
            "city": "LONE PINE",
            "state": "CA",
            "postal_code": "935451009",
            "telephone_number": "760-876-5501",
            "fax_number": "760-876-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBLER",
        "first_name": "GEORGE",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C37172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "C37172",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002086560",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA WORKERS COMP",
            "identifier": "0205422",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021672",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53941F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C371720",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00C371720",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "770051426001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "183283900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Pine, CA

Sources for this page

Verify at the official NPI Registry.