Loretta R Tibbels, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19666 Issued in NE

Practice address

2510 Bellevue Medical Center Dr Ste 145a
Bellevue, NE 68123-1556

Phone

(402) 779-7207

Fax

(402) 779-7210

NPI assigned

May 12, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Family Medicine

  Medicare reassignment NPD
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Fuquay Varina, NC
  • NPI 1326394990
  NPD
• Wake Specialty Physicians LLC

  • Pediatrics Physician
  • Fuquay Varina, NC
  • NPI 1578334892
  NPD

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1619927282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BELLEVUE MEDICAL CENTER DR STE 145A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231556",
            "telephone_number": "402-779-7207",
            "fax_number": "402-779-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BELLEVUE MEDICAL CENTER DR STE 145A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231556",
            "telephone_number": "402-779-7207",
            "fax_number": "402-779-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBELS",
        "first_name": "LORETTA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "19666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE LICENSE",
            "identifier": "19666",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherrina Thompson
• Victoria Lea Thompson
• Merlyn Rena Thornton
• Thrive Mental Health, LLC
• Steven Thyberg
• Keene Fulton Tiedemann
• Ashley M. Tietgen, DDS
• Dustin Tiller
• Assofuna Titora-Anara
• Derek J Tjepkes, PTA

• Family Medicine Physician in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.