Mary June Ibach, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP-14881 Issued in MD

Practice address

900 Virginia St. East Suite 500 Maxim Healthcare
Charleston, WV 25301

Phone

(681) 313-4759

NPI assigned

May 21, 2024

Last updated

May 21, 2024By the provider in NPPES

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 names 1

• Miss Mary June America Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1699514521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PROCESS RD.",
            "city": "HEDGEVILLE",
            "state": "WV",
            "postal_code": "25427",
            "telephone_number": "301-471-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA ST. EAST SUITE 500 MAXIM HEALTHCARE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "681-313-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBACH",
        "first_name": "MARY",
        "middle_name": "JUNE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP-14881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "AMERICA",
            "middle_name": "JUNE",
            "prefix": "MISS",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tammy Marie Hutchinston
• Angela Dawn Hutsenpiller, CRNA
• James Hyder
• Mae A. Hyre, DMD, MD
• Michael Patrick Iannetti, MD
• Yerassyl Ibragim, MD
• Ghali Ibrahim Bacha, MD
• Jessica Iczkowski
• Ignacio Z. Bernardo Jr., D.D.S., Inc.
• Rayan Elizabeth Ihle, M.D.

• Licensed Practical Nurse in Charleston, WV
• Providers in Charleston, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.