Individual provider Active NPI

Hannah Gibbs, DPT

  • Physical Therapist
  • Lewiston, ID
National Provider Identifier
1013396951
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4178 Issued in ID
Practice address
615 21St St
Lewiston, ID 83501-3285
Phone
(208) 413-7062
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4178 ID Primary

Addresses

Primary practice location

615 21St St
Lewiston, ID 83501-3285

Mailing address

PO Box 18
Lewiston, ID 83501-0018
Phone (208) 413-7062

Other practice location 1

1010 Bryden Ave
Ste A
Lewiston, ID 83501-5353
Phone (208) 746-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701002712 ID Practitioner - Physical Therapist in Private Practice 1658683743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Ohio State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 21St St
Lewiston, ID 83501-3285
Phone (980) 297-0839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4178IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vault Physical Therapy LLC Physical Therapist CurrentSince Feb 3, 2024 Accepting new patients
Peak Performance Physical Therapy Physical Therapist CurrentSince May 26, 2015 Accepting new patients

Locations

1010 Bryden Ave
Unit A
Lewiston, ID 83501
Phone (208) 746-0455

615 21st St
Lewiston, ID 83501
Phone (208) 413-7062

Organizations & group practices 2

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1013396951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835010018",
            "telephone_number": "208-413-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 21ST ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013285",
            "telephone_number": "208-413-7062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Bryden Ave",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835015353",
            "country_code": "US",
            "telephone_number": "208-746-0455",
            "fax_number": "208-746-0688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "HANNAH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT4178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.