Gibson White Drake LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

GIBSON WHITE DRAKE LLC

Doing business as

Jewel House

Practice address

11423 Saint Charles Rock Rd
Bridgeton, MO 63044-2724

Phone

(314) 246-9852

NPI assigned

Nov 10, 2020

Organization subpart

No

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

Authorized official

Name

Vernisia White

Title

Owner

Phone

(314) 246-9852

Specialties & licenses 2

Addresses

Other names 1

• Jewel House Doing business as

Locations

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1043812548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11423 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442724",
            "telephone_number": "314-246-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11423 SAINT CHARLES ROCK RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442724",
            "telephone_number": "314-246-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON WHITE DRAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "VERNISIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-246-9852"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jewel House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan M Gau, MD
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• Davina L George, NP
• Ramis Gheith, M.D.
• Raziya Gibson
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• Heather B Gilmore, DC, ATC
• Emily Marie Gilot, PT, DPT
• Joshua Stuart Glaser, MD

• Health Service Clinic/Center in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Health Service Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.