James Stacy Dibben, RN

Primary specialty

Hospice Registered NurseTaxonomy code 163WH1000X

License

2015001442 Issued in MO

Practice address

2311 S Redwood Ave Ste B
Independence, MO 64057-2405

Phone

(816) 365-0502

NPI assigned

Apr 22, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1245085323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SW 13TH ST",
            "city": "OAK GROVE",
            "state": "MO",
            "postal_code": "640759225",
            "telephone_number": "816-365-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 S REDWOOD AVE STE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572405",
            "telephone_number": "816-365-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBEN",
        "first_name": "JAMES",
        "middle_name": "STACY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "MO",
            "license": "2015001442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice Registered Nurse in Independence, MO
• Providers in Independence, MO by specialty
• Hospice Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.