Active NPI
Shelly Rae Tibke, CNP
- Family Nurse Practitioner
- Sioux Falls, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CP001053
- Practice address
- 911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049 - Phone
- (605) 334-0393
- Fax
- (605) 334-0393
- NPI assigned
- Apr 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R020920 | SD | |
| Family Nurse Practitioner | 363LF0000X | CP001053 | SD | Primary |
Addresses
Primary practice location
911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049
Mailing address
911 E 20TH St
Ste 700
Sioux Falls, SD 57105-1049
Phone (605) 334-0393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160523002549 | SD | Practitioner - Nurse Practitioner | 4789973264 | Reassigns benefits to 2 organizations |
| I20250805004067 | MN | Practitioner - Nurse Practitioner | 4789973264 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-8000
910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730
911 E 20TH St
Suite 700
Sioux Falls, SD 57105-1049
Phone (605) 334-0393
Hospital & facility affiliations
- Avera McKennan Hospital & University Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera Gettysburg | Current | Accepting new patients | |
| Pipestone County Medical Center | Current | Accepting new patients | |
| Pipestone County Medical Center | Current | Accepting new patients | |
| Pipestone County Medical Center | Current | Accepting new patients | |
| Surgical Institute of South Dakota, PC | Current | Accepting new patients | |
| Pipestone County Medical Center | Current | Accepting new patients |
Locations
916 4th Ave SW
Pipestone, MN 56164
Phone (507) 825-5811
606 E Garfield Ave
Ste C
Gettysburg, SD 57442
Phone (605) 765-2273
911 E 20th St
Ste 700
Sioux Falls, SD 57105
Phone (605) 322-7300
910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098
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.
-
- Family Medicine Physician
- Pipestone, MN
- NPI 1073576906
-
- Multi-Specialty Clinic/Center
- Pipestone, MN
- NPI 1831845262
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1487008686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 E 20TH ST",
"address_2": "STE 700",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051049",
"telephone_number": "605-334-0393",
"fax_number": "605-334-0393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 E 20TH ST",
"address_2": "STE 700",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051049",
"telephone_number": "605-334-0393",
"fax_number": "605-334-0393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBKE",
"first_name": "SHELLY",
"middle_name": "RAE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-14",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SD",
"license": "R020920",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SD",
"license": "CP001053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.