Individual provider Active NPI

Thomas James Gibson, RN

  • Registered Nurse
  • Willoughby, OH
National Provider Identifier
1013349398
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
372285 Issued in OH
Practice address
34866 S Turtle TRL Apt a
Willoughby, OH 44094-4258
Phone
(440) 463-8590
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 372285 OH Primary

Addresses

Primary practice location

34866 S Turtle TRL Apt a
Willoughby, OH 44094-4258

Mailing address

34866 S Turtle TRL Apt a
Willoughby, OH 44094-4258
Phone (440) 463-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
372285OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1013349398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34866 S TURTLE TRL APT A",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944258",
            "telephone_number": "440-463-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34866 S TURTLE TRL APT A",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944258",
            "telephone_number": "440-463-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "372285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.