Kakawonda T Hibbler, CFNP is a medicare enrolled "Nurse Practitioner - Family" physician in Indianola, Mississippi. Her current practice location is
702 Highway 82 E, Indianola, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 207-8492.
Kakawonda T Hibbler is licensed to practice in Mississippi (license number HIBB-HIF5DC) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578236964.
Physician's Profile
Full Name | Kakawonda T Hibbler |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 702 Highway 82 E, Indianola, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1578236964
- Provider Enumeration Date: 07/30/2021
- Last Update Date: 04/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 8628456688
- Enrollment ID: I20220602001866
Medical Identifiers
Medical identifiers for Kakawonda T Hibbler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578236964 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | HIBB-HIF5DC (Mississippi) | Secondary |
363LF0000X | Nurse Practitioner - Family | HIBB-HIF5DC (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kakawonda T Hibbler allows following entities to bill medicare on her behalf.
Entity Name | Innovative Healthcare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1184215584 PECOS PAC ID: 9133536626 Enrollment ID: O20210330000761 |
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Entity Name | Community Care Health Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210520000556 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kakawonda T Hibbler is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kakawonda T Hibbler, CFNP 640 Sunflower Avenue Ext, Indianola, MS 38751-2687 Ph: (662) 207-8492 | Kakawonda T Hibbler, CFNP 702 Highway 82 E, Indianola, MS 38751-2322 Ph: (662) 207-8492 |
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