Jack Bibeau

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN10455 Issued in NV

Practice address

10345 Professional Cir
Reno, NV 89521-5862

Phone

(775) 348-7300

NPI assigned

Jul 25, 2024

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1780412122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 PRATER WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894314122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10345 PROFESSIONAL CIR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215862",
            "telephone_number": "775-348-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBEAU",
        "first_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "LPN10455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BHC Health Services of Nevada Inc
• BHG Lxxxii, LLC (BHG Medical Services - Nevada)
• Shistata K Bhurtel, PHARM.D.
• Sri Charan Bhyravajosyula, M.B.B.S
• Alecia Lynn Biagi
• Britt Elizabeth Bickert, PA-C
• Jennifer Shellane Bickford, APRN
• Chad M Bidart, M.D.
• Kasi M Biegler
• Laura Quinn Biehle, PA-C

• Licensed Practical Nurse in Reno, NV
• Providers in Reno, NV by specialty
• Licensed Practical Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.