JOHANNAH MARIE MCKIBBEN RN, BSN, FNP, MSN
NPI 1104713437
Nurse Practitioner in Glenwood, IA

Q: What is Johannah Mckibben's NPI number?

The NPI number for Johannah Mckibben is 1104713437. It was assigned to this individual provider in the NPPES registry on June 19, 2025.

Q: What is Johannah Mckibben's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Johannah Mckibben was last updated on October 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 19, 2025PECOS EnrolledAccepts Medicare Assignment

320 EBAUGH ST, GLENWOOD, IA 51534(712) 624-9185(712) 396-4180 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 6, 2025, Jun 19, 2025 (2 updates tracked since 2025).

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About Johannah Marie Mckibben Rn, Bsn, Fnp, Msn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHANNAH MARIE MCKIBBEN RN, BSN, FNP, MSN (NPI 1104713437) is an individual nurse practitioner in Glenwood, Iowa, licensed in Nebraska (A186196) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Methodist Jennie Edmundson, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104713437

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJOHANNAH MARIE MCKIBBENCredential: RN, BSN, FNP, MSN

Location Address320 EBAUGH STGlenwood, IA 51534-1811

Mailing AddressPo Box 3755Omaha, NE 68103-0755 · (402) 354-2100 · Fax (402) 354-2155

Phone(712) 624-9185

Fax(712) 396-4180

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJune 19, 2025

Last NPPES UpdateOctober 17, 20252 updates tracked since enumeration

NPPES CertifiedOctober 17, 2025

✔ NPI 1104713437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NE · A186196

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

320 EBAUGH ST, Glenwood, IA 51534

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Wellmark Health Plan of Iowa, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Johannah Marie Mckibben Rn, Bsn, Fnp, Msn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466955794

PECOS Enrollment IDI20250912000826

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Johannah Mckibben reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physicians Clinic Inc

23 mi

Family Medicine

10060 REGENCY CIR
Omaha, NE 68114

Reassigned Medicare billing, Iowa enrollment
162 clinicians in this Medicare group

NPI 1821049156 (402) 354-1500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Jennie Edmundson

Acute Care Hospitals · Council Bluffs, IA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160047

Location933 East Pierce StreetCouncil Bluffs, IA 51503 · Pottawattamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 51534 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.84 typical visit price

range $52.96 – $161.40

Typical copayment $20.46 (range $13.24 – $40.35)

Most-billed visit code 99203

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON BLANKENSHIP

Nurse Practitioner