Mr Channon Lawrence Mckibben, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Marengo, Iowa. He graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Marengo Memorial Hospital and his current practice location is
300 W May St, Marengo, Iowa. You can reach out to his office (for appointments etc.) via phone at
(319) 642-5543.
Mr Channon Lawrence Mckibben is licensed to practice in Iowa (license number 117476) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1487189429.
Provider's Profile
| Full Name | Mr Channon Lawrence Mckibben |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 5 Years |
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| Location | 300 W May St, Marengo, Iowa |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Channon Lawrence Mckibben graduated from nursing school in 2019
NPI Data:
- NPI Number: 1487189429
- Provider Enumeration Date: 04/27/2017
- Last Update Date: 07/09/2019
Medicare PECOS Information:
- PECOS PAC ID: 6608208467
- Enrollment ID: I20191115001499
Medical Identifiers
Medical identifiers for Mr Channon Lawrence Mckibben such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487189429 | NPI | - | NPPES |
| 117476 | Other | IA | RN LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 117476 (Iowa) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Marengo Memorial Hospital | 0749199446 | 23 |
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. Mr Channon Lawrence Mckibben allows following entities to bill medicare on his behalf.
| Entity Name | Marengo Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053368191
PECOS PAC ID: 0749199446
Enrollment ID: O20040318000643 |
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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. Mr Channon Lawrence Mckibben 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 |
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Mr Channon Lawrence Mckibben,
300 W May St,
Marengo, IA 52301-1261
Ph: (319) 642-5543 | Mr Channon Lawrence Mckibben,
300 W May St,
Marengo, IA 52301-1261
Ph: (319) 642-5543 |
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