Loreen Faye Ibala, RN, BSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

337114 Issued in NY

Practice address

2420 Lake Avenue
Ashtabula, OH 44004

Phone

(440) 997-6910

NPI assigned

Feb 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: libala622956@direct.peacehealth.org

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.

• Peacehealth

  • Critical Access Hospital
  • Ketchikan, AK
  • NPI 1396705539
  Medicare reassignment NPD
• Peacehealth

  • Diagnostic Radiology Physician
  • Ketchikan, AK
  • NPI 1801965736
  Medicare reassignment NPD
• Astramed Physician PC

  • Ph.D. Medical Genetics
  • Saint Albans, NY
  • NPI 1831243807
  NPD (past)

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1497028146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 WEST 9TH STREET",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "44004",
            "telephone_number": "646-251-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 LAKE AVENUE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "44004",
            "telephone_number": "440-997-6910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Tongass Ave",
            "address_purpose": "LOCATION",
            "city": "Ketchikan",
            "state": "AK",
            "postal_code": "999015746",
            "country_code": "US",
            "telephone_number": "907-228-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBALA",
        "first_name": "LOREEN",
        "middle_name": "FAYE",
        "credential": "RN, BSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "210270",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Miranda Hupp, CDCA
• Heather Hutchinson
• Nichole Hutchinson, MED, PCC
• Michele Iarocci
• Julie Ann Imbrogno, LPN
• Michelle Imbrogno, LPN
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• Bethany Ellen Irish, CRNA
• Linda Joi Isenberg

• Family Nurse Practitioner in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.