Individual provider Active NPI

Noah Tibbetts

  • Community Health/Public Health Clinical Nurse Specialist
  • Laramie, WY
National Provider Identifier
1902620404
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health/Public Health Clinical Nurse SpecialistTaxonomy code 364SC1501X
License
NA Issued in WY
Practice address
1174 N 22ND St
Laramie, WY 82072-5401
Phone
(307) 766-3313
NPI assigned
Nov 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health/Public Health Clinical Nurse Specialist 364SC1501X NA WY Primary

Addresses

Primary practice location

1174 N 22ND St
Laramie, WY 82072-5401

Mailing address

3534 Willett Dr Apt 223a
Laramie, WY 82072-5129
Phone (303) 552-7849

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

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1902620404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 WILLETT DR APT 223A",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725129",
            "telephone_number": "303-552-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 N 22ND ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725401",
            "telephone_number": "307-766-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "NOAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC1501X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "WY",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.