Organization Active NPI

Debra Gibbons LLC

  • Marriage & Family Therapist
  • St.George, UT
National Provider Identifier
1063260370
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
DEBRA GIBBONS LLC
Practice address
321 N. Mall Dr. BLDG. O
#101
St.George, UT 84790
Phone
(435) 868-8376
Fax
(435) 635-9720
NPI assigned
May 10, 2024
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Debra Gibbons, M.F.T.NPI 1467774638
Title
Owner
Phone
(435) 868-8376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

321 N. Mall Dr. BLDG. O
#101
St.George, UT 84790

Mailing address

321 N. Mall Dr. BLDG. O
#101
St.George, UT 84790
Phone (435) 868-8376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240620001097 UT Part B Supplier - Clinic/Group Practice 3375086275 Receives reassigned benefits from 1 practitioner
Practice locations: St George, UT

National Provider Directory

National Provider Directory

Locations

321 N Mall Dr
Bldg O
St George, UT 84790
Phone (435) 868-8376

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1063260370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N. MALL DR. BLDG. O",
            "address_2": "#101",
            "city": "ST.GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-868-8376",
            "fax_number": "435-635-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N. MALL DR. BLDG. O",
            "address_2": "#101",
            "city": "ST.GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-868-8376",
            "fax_number": "435-635-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA GIBBONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-868-8376",
        "authorized_official_credential": "M.F.T."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St.George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.