Debra K Leibel, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R016114 Issued in SD

Practice address

809 Jackson St
Burke, SD 57523-2065

Phone

(605) 775-2631

Fax

(605) 775-2564

NPI assigned

Jun 23, 2005

Reactivated

Aug 1, 2007

Last updated

Oct 25, 2022By 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 identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Burke Ambulance Service Inc

  • Land Ambulance
  • Burke, SD
  • NPI 1578889523
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1356347496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 JACKSON ST",
            "city": "BURKE",
            "state": "SD",
            "postal_code": "575230358",
            "telephone_number": "605-775-2631",
            "fax_number": "605-775-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 JACKSON ST",
            "city": "BURKE",
            "state": "SD",
            "postal_code": "575232065",
            "telephone_number": "605-775-2631",
            "fax_number": "605-775-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBEL",
        "first_name": "DEBRA",
        "middle_name": "K",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "R016114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6823700",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF SD",
            "identifier": "4997517",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lynne.bentz@cmhburke.org",
            "affiliation": "N",
            "address_1": "809 Jackson St",
            "city": "Burke",
            "state": "SD",
            "country_code": "US",
            "postal_code": "575232065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Vladik Johnson
• Amy S Juracek, CNP
• Brittney Michele Korthals, CNP
• Natasha Rae Martin
• Sanford Healthcare Accessories, LLC (Sanford Health Equip)
• Megan M Smith, M.D.
• Kelsey Shannon Soles
• Thrive Chiropractic LLC

• Family Nurse Practitioner in Burke, SD
• Providers in Burke, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.