Lucas Tibor, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2458181 Issued in MN

Practice address

711 Kasota Ave SE
Minneapolis, MN 55414-2842

Phone

(612) 672-2233

NPI assigned

Jan 1, 2022

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

Other identifiers 1

Electronic endpoints 1

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": "1640995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1285395376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842",
            "telephone_number": "612-672-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBOR",
        "first_name": "LUCAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-01",
        "last_updated": "2022-01-01",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2458181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF NURSING",
            "identifier": "2458181",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fairviewhomeinfusion.org",
            "affiliation": "Y",
            "affiliationName": "Fairview Pharmacy Services, LLC",
            "address_1": "711 Kasota Ave SE",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554142842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erica Thyen
• Jen Thymian, LICSW
• Khine Mira Tian, PA-C
• Emebeat A Tibebu
• Robert James Tibesar, MD
• Michelle M Tichey, MD
• Luan Shiloh Tichy
• Layne Ticker
• Blake Ryan Tidwell, MD
• Cody D. Tidwell, MD

• Registered Nurse in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; 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.