Michelle Raina Tibbens, MSN, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024188279 Issued in VA

Practice address

102 Run Swamp Rd
Camden, NC 27921-7625

Phone

(814) 553-2117

NPI assigned

Sep 26, 2023

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in VA

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hampton Roads Behavioral Health,PCGroup PAC ID 9739070780, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hampton Roads Behavioral Health,PC

  • Mental Health Counselor
  • Norfolk, VA
  • NPI 1356394696
  Medicare reassignment Care Compare group NPD
• Portsmouth Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Portsmouth, VA
  • NPI 1134199193

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Portsmouth Community Health Center Inc

  dba Little Creek Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Norfolk, VA
  • NPI 1144604877
  NPD
• Portsmouth Community Health Center Inc

  dba East Ocean View

  • Federally Qualified Health Center (FQHC)
  • Norfolk, VA
  • NPI 1871848184
  NPD

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1942089206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RUN SWAMP RD",
            "city": "CAMDEN",
            "state": "NC",
            "postal_code": "279217625",
            "telephone_number": "814-553-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 RUN SWAMP RD",
            "city": "CAMDEN",
            "state": "NC",
            "postal_code": "279217625",
            "telephone_number": "814-553-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBENS",
        "first_name": "MICHELLE",
        "middle_name": "RAINA",
        "credential": "MSN, APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024188279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Cole Rosenberger, M.S., O.T.R.L
• St. Jude's Ministries Inc.
• Amber Stone-Aguirre, MS
• Sutton Wellness Center LLC
• Delaine Thiele Tanis, M.A., CCC-SLP
• Todds Pharmacy of Camden, Inc
• Todds Pharmacy of Camden, Inc

• Psychiatric/Mental Health Nurse Practitioner in Camden, NC
• Providers in Camden, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.