Hettie Susie Gibbs, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13743 Issued in TN

Practice address

661 Madison Ave
Suite a
Memphis, TN 38103-3307

Phone

(901) 527-2417

Fax

(901) 522-9646

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1023068277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 MADISON AVE",
            "address_2": "SUITE A",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033307",
            "telephone_number": "901-527-2417",
            "fax_number": "901-522-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 MADISON AVE",
            "address_2": "SUITE A",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033307",
            "telephone_number": "901-527-2417",
            "fax_number": "901-522-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "HETTIE",
        "middle_name": "SUSIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "13743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019528",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Umme Kulsoom Ghous
• Kristy Gibbons, MS,RD, CSP, CSO, LDN
• Carol D Gibbs, BS
• Dayna E Gibbs, M.D.
• Debra Gibbs, MSW
• Patricia Ann Gibbs, DPH
• Richard Bartholomew Gibbs, M.D.
• Andrew Bates Gibson III, MS, ATC/L
• Asia Gibson, BCBA, LBA
• Asia L Gibson, LCSW

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.