Individual provider Active NPI

Anjanette Kibby, FNP-C

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1255091104
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TEMP266412 Issued in AZ
Practice address
4045 W Chandler Blvd BLDG F
Chandler, AZ 85226-3732
Phone
(480) 494-2062
Fax
(480) 353-2066
NPI assigned
Dec 20, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TEMP266412 AZ Primary

Addresses

Primary practice location

4045 W Chandler Blvd BLDG F
Chandler, AZ 85226-3732

Mailing address

4045 W Chandler Blvd BLDG F
Chandler, AZ 85226-3732
Phone (480) 494-2062

Other identifiers 1

IdentifierTypeStateIssuer
TEMP266412OtherAZNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20220401001828 AZ Practitioner - Nurse Practitioner 8426444373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brain and Spine Center PLCGroup PAC ID 4789713843, 7 clinicians

Practice addresses (Care Compare)

1760 E Florence Blvd
Suite 250
Casa Grande, AZ 85122-4769
Phone (480) 917-3706

4045 W Chandler Blvd
BLDG F
Chandler, AZ 85226-3732
Phone (480) 494-2061

4045 W Chandler Blvd BLDG F
Chandler, AZ 85226-3732

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.67 of 100Reported as group
Quality
94.26
Promoting interoperability
87
Improvement activities
40
Cost
75.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TEMP266412AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brain and Spine Center PLC CurrentSince Dec 1, 2021 Accepting new patients
Brain and Spine Center PLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

1760 E Florence Blvd
Ste 250
Casa Grande, AZ 85122
Phone (480) 494-2062

655 S Dobson Rd
Ste 103
Chandler, AZ 85224
Phone (480) 508-1255

4045 W Chandler Blvd
Bldg F
Chandler, AZ 85226
Phone (480) 494-2061

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1255091104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 W CHANDLER BLVD BLDG F",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263732",
            "telephone_number": "480-494-2062",
            "fax_number": "480-353-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 W CHANDLER BLVD BLDG F",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263732",
            "telephone_number": "480-494-2062",
            "fax_number": "480-353-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBBY",
        "first_name": "ANJANETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TEMP266412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "TEMP266412",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.