SHELLY RAE TIBKE (NPI# 1487008686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487008686 |
Entity Type | Individual |
Full Name | SHELLY RAE TIBKE |
Credential | CNP |
Practice Address |
911 E 20th St Ste 700 Sioux Falls SD 57105-1049 |
Practice Telephone | 6053340393 |
Practice Fax Number | 6053340393 |
Mailing Telephone | 6053340393 |
Mailing Fax Number | 6053340393 |
Enumeration Date | 2016-04-14 |
Last Update Date | 2016-06-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | R020920 | SD | Nursing Service Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP001053 | SD | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
911 E 20TH ST STE 700 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-1049 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972506939 | Dakota Surgical Ltd | Clinic/Center | 911 E 20th St, Ste 300, Sioux Falls, SD 57105-1045 | 2005-05-24 |
1447507660 | Dana J Buus | Nurse Practitioner | 911 E 20th St, Suite 405, Sioux Falls, SD 57105-1042 | 2012-08-07 |
1912267030 | Oluma Yoseph Bushen | Internal Medicine | 911 E 20th St, Suite 509, Sioux Falls, SD 57105-1042 | 2012-05-23 |
1942572086 | Trichelle Grace Petermann | Nurse Practitioner | 911 E 20th St, Ste 400, Sioux Falls, SD 57105-1042 | 2012-02-06 |
1770813651 | Gwen Lynn Smith | Physician Assistant | 911 E 20th St, Ste 700, Sioux Falls, SD 57105-1049 | 2009-12-28 |
1578783213 | Virginia K Trumbull | Dietitian, Registered | 911 E 20th St, Physicians Office Building, Suite 600, Sioux Falls, SD 57105-1042 | 2007-04-26 |
1093833840 | Michael R. Puumala, M.d.,p.c. | Specialist | 911 E 20th St, Suite 400, Sioux Falls, SD 57105-1042 | 2007-03-27 |
1174647655 | Mary E. Kinney | Registered Nurse | 911 E 20th St, Sioux Falls, SD 57105-1042 | 2007-03-19 |
1699818252 | Delaina Patricia Sievers | Physician Assistant | 911 E 20th St, Suite 303, Sioux Falls, SD 57105-1042 | 2007-02-14 |
1821136219 | Michael Shawn Bauer | Surgery | 911 E 20th St, Ste 700, Sioux Falls, SD 57105-1049 | 2007-02-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
Find all providers in zip 57105 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922625854 | Mindy Thompson | Nurse Practitioner | 2501 S Louis Ave, Sioux Falls, SD 57109-4601 | 2020-06-26 |
1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
1013567627 | Kasandra Wheeler | Nurse Practitioner | 1309 W 17th St Ste 1, Sioux Falls, SD 57104-4663 | 2019-09-16 |
1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
1679081350 | Abby Jo Viereck | Nurse Practitioner | 2301 E 60th St N, Sioux Falls, SD 57104-0569 | 2018-01-17 |
1356851661 | Alyssa Mae Welbig | Nurse Practitioner | 2315 W 57th St Ste 300, Sioux Falls, SD 57108-5163 | 2017-10-02 |
1023565645 | Amanda Glanzer | Nurse Practitioner | 7701 W 65th St, Sioux Falls, SD 57106-8802 | 2016-09-01 |
1750737318 | Steven Davis | Nurse Practitioner | 7231 W Chesapeake Ln, Sioux Falls, SD 57106-3842 | 2016-05-12 |
1609231943 | Jena Burgess | Nurse Practitioner | 1417 S Cliff Ave Ste 300, Sioux Falls, SD 57105-1062 | 2015-12-30 |
1093154213 | Jamie Kay Grant | Nurse Practitioner | 5009 S Louise Ave, Sioux Falls, SD 57108-2268 | 2013-06-20 |
Find all providers in SIOUX FALLS |
City | SIOUX FALLS |
Zip Code | 57105 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.