Individual provider Active NPI

Charles Curtis Gipson, M.D.

  • Optometrist
  • Biloxi, MS
National Provider Identifier
1053389627
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14481 Issued in MS
Practice address
431 Bertucci Blvd
Biloxi, MS 39531-2255
Phone
(228) 385-2020
Fax
(228) 388-9435
NPI assigned
Mar 9, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14481 MS Primary

Addresses

Primary practice location

431 Bertucci Blvd
Biloxi, MS 39531-2255

Mailing address

431 Bertucci Blvd
Biloxi, MS 39531-2255
Phone (228) 385-2020

Other identifiers 1

IdentifierTypeStateIssuer
00880065MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1053389627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 BERTUCCI BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312255",
            "telephone_number": "228-385-2020",
            "fax_number": "228-388-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 BERTUCCI BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312255",
            "telephone_number": "228-385-2020",
            "fax_number": "228-388-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "CHARLES",
        "middle_name": "CURTIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "14481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880065",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.