NPIMap

Individual provider Active NPI

Laura Jill Tibbe, MD

  • Family Medicine Physician
  • Lawrenceburg, IN
National Provider Identifier
1356310379
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01054918A Issued in IN
Practice address
2018 Jamison Drive
Lawrenceburg, IN 47025-8436
Phone
(812) 496-8773
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01054918A IN Primary

Addresses

Primary practice location

2018 Jamison Drive
Lawrenceburg, IN 47025-8436

Mailing address

PO Box 4125
Lawrenceburg, IN 47025
Phone (812) 637-2082

Other practice location 1

24129 Professional Park Dr
Lawrenceburg, IN 47025-7603
Phone (812) 496-8773

Other identifiers 2

IdentifierTypeStateIssuer
0941324MedicaidOH
200349640MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20071127000648 IN Practitioner - Family Practice 0840389953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

2018 Jamison Dr
St Elizabeth Physicians
Lawrenceburg, IN 47025-8436
Phone (812) 496-8773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01054918AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince Dec 7, 2020 Accepting new patients
Major Hospital Past Accepting new patients
Summit Medical Group, Inc Family Medicine Past Accepting new patients
Health Services Corporation of Southeastern Indiana Past Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

24129 Professional Park Dr
#101
Lawrenceburg, IN 47025
Phone (812) 532-2800

24129 Professional Park Dr
Lawrenceburg, IN 47025
Phone (812) 496-8773

1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285

24129 Professional Park Dr
#D
Lawrenceburg, IN 47025
Phone (812) 637-1370

2018 Jamison Dr
Lawrenceburg, IN 47025
Phone (812) 496-8772

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

Interoperability endpoints

  • Direct secure messaging: ltibbe333907@direct-prd.stelizabeth.com

Organizations & group practices 6

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 11

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1356310379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4125",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "47025",
            "telephone_number": "812-637-2082",
            "fax_number": "812-637-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 JAMISON DRIVE",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470258436",
            "telephone_number": "812-496-8773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24129 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "IN",
            "postal_code": "470257603",
            "country_code": "US",
            "telephone_number": "812-496-8773",
            "fax_number": "812-637-1103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIBBE",
        "first_name": "LAURA",
        "middle_name": "JILL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01054918A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0941324",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200349640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

Verify at the official NPI Registry.