Laurie Muriel Jibben, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

085071 Issued in MO

Practice address

1200 N One Mile Rd
Dexter, MO 63841-1000

Phone

(573) 624-7575

Fax

(573) 614-1966

NPI assigned

Sep 13, 2005

Last updated

Jan 12, 2017By the provider in NPPES

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

Other names 1

• Laurie M Kaczmarek Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dexter Hospital, LLCGroup PAC ID 6507834579, 16 clinicians

Southeast Health Center of Stoddard County LLCGroup PAC ID 7315192515, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Dexter, MO, CCN 267589
• Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • Rural Health Clinic/Center
  • Dexter, MO
  • NPI 1790828812
  Medicare reassignment Care Compare group NPD
• Dexter Hospital LLC

  dba Jibben Medical

  • Rural Health Clinic/Center
  • Dexter, MO
  • NPI 1710056213
  NPD (past)

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

• Poplar Bluff Regional Medical Center LLC

  dba Poplar Bluff Regional Medical Center

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724
  Care Compare affiliation
• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • General Acute Care Hospital
  • Dexter, MO
  • NPI 1801990825
  Care Compare affiliation
• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation
• Tri County Home Health, Inc.

  dba Elara Caring

  • Home Health Agency
  • Dexter, MO
  • NPI 1881641090
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1285629543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N ONE MILE RD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411000",
            "telephone_number": "573-624-5566",
            "fax_number": "573-614-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N ONE MILE RD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411000",
            "telephone_number": "573-624-7575",
            "fax_number": "573-614-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBBEN",
        "first_name": "LAURIE",
        "middle_name": "MURIEL",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "085071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "KACZMAREK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Elaine Hubbard, FNP-C
• Kelly R Hutson, D.C.
• Reza Jalal, MD
• Zulekha Safiya Jalal, MD
• James Larry Warren (MicroEar Hearing Aid Center)
• Robert J Jibben, DO
• Susan Caroline Jones, PT
• Brandi Nichole Juden, NP-C
• William T Kane, D.D.S., M.B.A.
• Samantha Lee Karmas

• Family Nurse Practitioner in Dexter, MO
• Providers in Dexter, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.