NPIMap

Individual provider Active NPI

Jessie Hibner, FNP

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1255853909
Registry record updated Dec 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201909322NP-PP Issued in OR
Practice address
2859 State St Ste 101
Medford, OR 97504-8495
Phone
(541) 282-6505
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 200541452RN OR
Family Nurse Practitioner 363LF0000X 201909322NP-PP OR Primary

Addresses

Primary practice location

2859 State St Ste 101
Medford, OR 97504-8495

Mailing address

2859 State St Ste 101
Medford, OR 97504-8495
Phone (541) 789-3040

Other practice location 1

1066 Tamara Cir
Medford, OR 97504-8533
Phone (541) 621-5958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200131002662 OR Practitioner - Nurse Practitioner 3971939406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rogue Valley PhysiciansGroup PAC ID 1850374240, 22 clinicians
King Health and Wellness LLCGroup PAC ID 3375912694, 3 clinicians

Practice addresses (Care Compare)

2900 Doctors Park Dr
Suite 250
Medford, OR 97504-4348
Phone (541) 282-2208

585 Murphy Rd
Medford, OR 97504-8128
Phone (541) 500-4747

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rogue Valley Physicians PC Family CurrentSince Oct 21, 2024 Accepting new patients
Rogue Valley Physicians Current Accepting new patients
King Health & Wellness, LLC CurrentSince Jul 1, 2025 Accepting new patients
Rogue Valley Physicians CurrentSince Oct 21, 2024 Accepting new patients

Locations

585 Murphy Rd
Medford, OR 97504
Phone (541) 500-4747

2859 State St
Ste 101
Medford, OR 97504
Phone (541) 282-6505

2900 Doctors Park Dr
Ste 250
Medford, OR 97504
Phone (541) 282-2208

Interoperability endpoints

  • Direct secure messaging: kinghealthandwellness.jessiehibnerg@161511.advancedmd-direct.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576281600000",
    "number": "1255853909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 STATE ST STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048495",
            "telephone_number": "541-789-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 STATE ST STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048495",
            "telephone_number": "541-282-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1066 Tamara Cir",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048533",
            "country_code": "US",
            "telephone_number": "541-621-5958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIBNER",
        "first_name": "JESSIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OR",
            "license": "200541452RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201909322NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.