Active NPI
Milo Lavon Hibbert, M.D.
- Obstetrics & Gynecology Physician
- La Grande, OR
National Provider Identifier
1689604233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD11673
- Practice address
- 610 Sunset Dr
La Grande, OR 97850-1248 - Phone
- (541) 963-2216
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD11673 | OR | Primary |
Addresses
Primary practice location
610 Sunset Dr
La Grande, OR 97850-1248
Mailing address
610 Sunset Dr
La Grande, OR 97850-1248
Phone (541) 963-2216
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930505325014 | Other | OR | EMPLOYER ID NUMBER |
| H1254 01 | Other | OR | PACIFIC SOURCE |
| 212001 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD11673 | OR | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grande Ronde Hospital Inc. | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- La Grande, OR
- NPI 1972545895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689604233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 SUNSET DR",
"city": "LA GRANDE",
"state": "OR",
"postal_code": "978501248",
"telephone_number": "541-963-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 SUNSET DR",
"city": "LA GRANDE",
"state": "OR",
"postal_code": "978501248",
"telephone_number": "541-963-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIBBERT",
"first_name": "MILO",
"middle_name": "LAVON",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OR",
"license": "MD11673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER ID NUMBER",
"identifier": "930505325014",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC SOURCE",
"identifier": "H1254 01",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212001",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Grande, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.