NPIMap

Individual provider Active NPI

Jessica Lail Libicer, PA-S

  • Physician Assistant
  • Buies Creek, NC
National Provider Identifier
1730995077
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
PO Box 1090
Buies Creek, NC 27506-1090
Phone
(800) 760-9734
NPI assigned
Dec 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

PO Box 1090
Buies Creek, NC 27506-1090

Mailing address

PO Box 1090
Buies Creek, NC 27506-1090
Phone (800) 760-9734

Other names 1

  • Jessica Pauline Lail Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251204002800 SD Practitioner - Physician Assistant 2769975051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

1440 N Main St
Spearfish, SD 57783-1505
Phone (605) 644-4000

Hospital & facility affiliations

  • Monument Health Spearfish Hospital Hospital, Spearfish, SD, CCN 430048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Network, Inc. CurrentSince Sep 17, 2025 Accepting new patients
Monument Health Network, Inc. CurrentSince Sep 17, 2025 Accepting new patients
Queen City Regional Medical Clinic Physician Assistant Past Accepting new patients

Locations

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1730995077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "275061090",
            "telephone_number": "800-760-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "275061090",
            "telephone_number": "800-760-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBICER",
        "first_name": "JESSICA",
        "middle_name": "LAIL",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LAIL",
            "middle_name": "PAULINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buies Creek, NC

Sources for this page

Verify at the official NPI Registry.