Mika J Tibbs, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R037153 Issued in SD

Practice address

317 N Main St
Eagle Butte, SD 57625-1012

Phone

(605) 964-3004

NPI assigned

Jul 14, 2009

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indian Health Services

  • Rural Acute Care Hospital
  • Eagle Butte, SD
  • NPI 1720230709
  NPD (past)

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1255560066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1012",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251012",
            "telephone_number": "605-964-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251012",
            "telephone_number": "605-964-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "MIKA",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R037153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laree Stevens
• Minda Rae Stuthman
• Karen Ann Sussman, RN
• Theresa Tatten, RN
• Diane Jeanne Thalheimer, RN
• Minerva Torres-Sierra, RN
• Rachel Truax, RN
• Jacob R. Turin, PHARMD
• Margaret L Upell, MD
• Candace Mae Veit, FNP-C

• Registered Nurse in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.