Siata Anica Gibson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R175106 Issued in MD

Practice address

4467 Old Branch Ave Ste 207
Temple Hills, MD 20748-1854

Phone

(301) 630-3900

NPI assigned

Aug 18, 2018

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

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Ebrown-Sgibson NP PC Inc.

  • Nurse Practitioner
  • Temple Hills, MD
  • NPI 1841973831

  DC

  Medicare reassignment NPD Authorized official
• First Clinic, LLC

  • Family Nurse Practitioner
  • Potomac, MD
  • NPI 1427330463
  NPD (past)
• Elevate Health Solutions, LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1437974961

  Family

  NPD (past)

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

{
    "created_epoch": "1534550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1023598091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 EARLY APRIL WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461473",
            "telephone_number": "240-277-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4467 OLD BRANCH AVE STE 207",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481854",
            "telephone_number": "301-630-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SIATA",
        "middle_name": "ANICA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-18",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R175106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivanthidevi Gandhi, MD
• Denise Celess Garris
• Gatekeeper Enterprises, LLC (Portera Rehabilitation)
• La Tasha Gaynor
• Katie Gerhardt
• Gig Pharmacy and Home Healthcare Services LLC (Gig Pharmacy and Home Healthcare)
• Carla Gilham I
• Global Medical Group Practice, LLC
• William Tyron Glover
• Stephanie Godoy

• Family Nurse Practitioner in Temple Hills, MD
• Providers in Temple Hills, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.