Tammy Charlyn Gibson, RPH DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

9030 Issued in KY

Practice address

200 N Hurstbourne Pkwy Ste 174
Louisville, KY 40222-5138

Phone

(502) 690-4462

Fax

(502) 690-4466

NPI assigned

Jan 10, 2023

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)

Not enrolled

Credentials

Registered Pharmacist

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 and National Provider Directory roles.

• St. Matthews Pharmacy LLC

  • Long Term Care Pharmacy
  • Louisville, KY
  • NPI 1699319814
  NPD
• St. Matthews Pharmacy LLC

  • Pharmacy
  • Louisville, KY
  • NPI 1760815823
  NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1053025494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9344 CROSS MEADOWS CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402915618",
            "telephone_number": "502-797-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N HURSTBOURNE PKWY STE 174",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225138",
            "telephone_number": "502-690-4462",
            "fax_number": "502-690-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TAMMY",
        "middle_name": "CHARLYN",
        "name_prefix": "Mrs.",
        "credential": "RPH DPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "9030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "P009030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Gibson, OD
• Makenna Brianne Gibson, DMD
• Marcus A Gibson, DMD
• Melissa Ann Gibson, PSYD
• Richard Gibson, M.D.
• William Tyler Gibson, OD
• Erin Lorena Gick, OTD, OTR
• Amanda Catherine Marie Giesecke, APRN
• Jessica Rosalie Giesel, PA-C
• Thomas Giesen, MD

• Pharmacist in Louisville, KY
• Providers in Louisville, KY by specialty
• Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.