Individual provider Active NPI

Colleen Marie Hibbert, RN,MSN,PNP

  • Pediatric Nurse Practitioner
  • Concord, NC
National Provider Identifier
1780702191
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
20060225 Issued in NC
Practice address
1040 Vinehaven Drive
Concord, NC 28025-2438
Phone
(704) 784-1010
Fax
(704) 784-1013
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 20060225 NC Primary

Addresses

Primary practice location

1040 Vinehaven Drive
Concord, NC 28025-2438

Mailing address

5772 Windward CT NW
Concord, NC 28027-9027
Phone (919) 749-4158

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
20060225NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Children'S Clinic Past Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chibbert3006265@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1780702191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5772 WINDWARD CT NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280279027",
            "telephone_number": "919-749-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 VINEHAVEN DRIVE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252438",
            "telephone_number": "704-784-1010",
            "fax_number": "704-784-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBERT",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN,MSN,PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "20060225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.