Michelle J Ibsen, M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

C7294 Issued in AR

Practice address

3470 Landers Rd
North Little Rock, AR 72117-2541

Phone

(615) 778-4066

NPI assigned

Mar 20, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1699890749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000",
            "fax_number": "214-775-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 LANDERS RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172541",
            "telephone_number": "615-778-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBSEN",
        "first_name": "MICHELLE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "AR",
            "license": "C7294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preventive Medicine/Occupational Environmental Medicine Physician in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.