Jessie Lee Kibbe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2432 E Main St
Jackson, MO 63755-2664

Phone

(573) 755-2305

Fax

(800) 800-5123

NPI assigned

Sep 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MO, PA3 enrollments

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 3

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Southeast Missouri Hospital Physicians, LLC

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment Care Compare group
• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477
  Medicare reassignment Care Compare group
• Advanced Diagnostic Imaging, PC

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  Medicare reassignment NPD
• Advanced Diagnostic Imaging PC

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD
• Southeast Hospital

  • Community/Retail Pharmacy
  • Cape Girardeau, MO
  • NPI 1336150846
  NPD (past)

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

• Southeast Hospital

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation
• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  Care Compare affiliation

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1457073876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 E MAIN ST",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552664",
            "telephone_number": "573-755-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 E MAIN ST",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552664",
            "telephone_number": "573-755-2305",
            "fax_number": "800-800-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBBE",
        "first_name": "JESSIE",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Leeann Kasten
• Elise Keele
• Alison Keiper
• Allison Keith
• Vicki Lynn Keller, P.T.
• April F Kibble, MSN, FNP-BC
• William Bradley King, DDS
• Lesley Kluesner, M.A.,CCC-SLP
• Khloe Ann Koch, OTR
• Seth Tyler Koehler, D.O.

• Physician Assistant in Jackson, MO
• Providers in Jackson, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.