Individual provider Active NPI

Maria Recurt Hibdon, FNP

  • Nurse Practitioner
  • Roseville, CA
National Provider Identifier
1881630085
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
285715 Issued in CA
Practice address
406 Sunrise Ave
Suite 280
Roseville, CA 95661-4106
Phone
(916) 782-3786
Fax
(916) 773-6251
NPI assigned
Jun 22, 2006
Last updated
Feb 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 285715 CA Primary

Addresses

Primary practice location

406 Sunrise Ave
Suite 280
Roseville, CA 95661-4106

Mailing address

406 Sunrise Ave
Suite 280
Roseville, CA 95661-4106
Phone (916) 782-3786

Other identifiers 1

IdentifierTypeStateIssuer
00G527460MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
285715CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1881630085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE",
            "address_2": "SUITE 280",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614106",
            "telephone_number": "916-782-3786",
            "fax_number": "916-773-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE",
            "address_2": "SUITE 280",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614106",
            "telephone_number": "916-782-3786",
            "fax_number": "916-773-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBDON",
        "first_name": "MARIA",
        "middle_name": "RECURT",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "285715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G527460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.