Donald Bruce Niebel, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4120 Issued in SD

Practice address

943 Hualapai Way
Peach Springs, AZ 86434

Phone

(928) 769-2900

NPI assigned

Jul 20, 2006

Last updated

Mar 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Winnebago Indian Health Service

  • General Acute Care Hospital
  • Winnebago, NE
  • NPI 1659392454
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1407876386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "address_2": "943 HUALAPAI WAY",
            "city": "PEACH SPRINGS",
            "state": "AZ",
            "postal_code": "86434",
            "telephone_number": "928-769-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 HUALAPAI WAY",
            "city": "PEACH SPRINGS",
            "state": "AZ",
            "postal_code": "86434",
            "telephone_number": "928-769-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBEL",
        "first_name": "DONALD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4120",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20885",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99999801",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean P Kennedy, MA
• Perci V La-Nae, LMSW
• Anita B. Mapatis
• Leslie McGuire, RN
• Scott H Myers, PHARMD
• Julia G. O'Brien, RN
• Peach Springs Health Center
• Peach Springs Indian Health Center
• Peach Springs Unified School District #8 (Psusd #8)
• Vernie Phillips Jr., LMSW, LISAC

• Family Medicine Physician in Peach Springs, AZ
• Providers in Peach Springs, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.