Individual provider Active NPI

Janice Lynn Gibbons, M.D.

  • Pediatrics Physician
  • Paris, TX
National Provider Identifier
1003997099
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P1866 Issued in TX
Practice address
3150 Clarksville St
Suite 100
Paris, TX 75460-8076
Phone
(903) 782-9206
Fax
(903) 783-7367
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P1866 TX Primary

Addresses

Primary practice location

3150 Clarksville St
Suite 100
Paris, TX 75460-8076

Mailing address

3150 Clarksville St
Suite 100
Paris, TX 75460-8076
Phone (903) 782-9206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420001904 TX Practitioner - Pediatric Medicine 3375707268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Special Health Resources for Texas, Inc CurrentSince Feb 6, 2020 Accepting new patients
Special Health Resources for Texas, Incorporated CurrentSince Feb 6, 2020 Accepting new patients
Special Health Resources for Texas, Incorporated Current Accepting new patients
Essent PRMC LP Past Accepting new patients
Special Health Resources for Texas, Incorporated Past Accepting new patients

Locations

2030 S High St
Longview, TX 75602
Phone (903) 234-0936

409 N 6th St
Longview, TX 75601
Phone (903) 315-5520

3150 Clarksville St
Ste 100
Paris, TX 75460
Phone (903) 782-9206

3150 Clarksville St
Ste 300
Paris, TX 75460
Phone (877) 785-8750

Interoperability endpoints

  • Direct secure messaging: janice.gibbons@wchcl.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AFADCA

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1003997099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CLARKSVILLE ST",
            "address_2": "SUITE 100",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754608076",
            "telephone_number": "903-782-9206",
            "fax_number": "903-783-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CLARKSVILLE ST",
            "address_2": "SUITE 100",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754608076",
            "telephone_number": "903-782-9206",
            "fax_number": "903-783-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P1866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TX

Sources for this page

Verify at the official NPI Registry.