Kathleen Gibson, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA9120235 Issued in FL

Practice address

146 Orange PL
Maitland, FL 32751-6531

Phone

(407) 389-2020

NPI assigned

Sep 8, 2025

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

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Derrow Dermatology Associates LLC

  • Dermatology Physician
  • Maitland, FL
  • NPI 1952555039

  Single Specialty

  NPD

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1063392272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 ORANGE PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516531",
            "telephone_number": "407-389-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ORANGE PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516531",
            "telephone_number": "407-389-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9120235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikkida Shiree Ghent, FNP
• Shanchita Ghosh, M.D.
• Tejanique Gibbs
• Jared Gibby, DMD
• Hinano Sophia Gibson
• Victoria Gibson
• Bianca Gifford
• Tammy Gillis Negri, MS
• Christina Marie Gillmore, APRN
• Amy Ginsburg, CFY

• Dermatology Physician in Maitland, FL
• Providers in Maitland, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.