Individual provider Active NPI

Deborah Brett Bibb, MD

  • General Practice Physician
  • Fayetteville, AR
National Provider Identifier
1245223841
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R-3671 Issued in AR
Practice address
1188 N Salem Rd
Suite 6
Fayetteville, AR 72704-8808
Phone
(479) 442-0006
Fax
(479) 442-3038
NPI assigned
Aug 30, 2005
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X R-3671 AR Primary

Addresses

Primary practice location

1188 N Salem Rd
Suite 6
Fayetteville, AR 72704-8808

Mailing address

PO Box 3531
Fayetteville, AR 72702-3531
Phone (479) 442-0006

Other identifiers 1

IdentifierTypeStateIssuer
AR BC/BSOtherAR52191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-3671ARMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Primary Care of Memphis PC Past Accepting new patients

Organizations & group practices 1

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1245223841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3531",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727023531",
            "telephone_number": "479-442-0006",
            "fax_number": "479-442-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 N SALEM RD",
            "address_2": "SUITE 6",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727048808",
            "telephone_number": "479-442-0006",
            "fax_number": "479-442-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBB",
        "first_name": "DEBORAH",
        "middle_name": "BRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "R-3671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "52191",
            "identifier": "AR BC/BS",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.