Phillip Gregory Gibson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

06982PT Issued in CA

Practice address

840 Hartnell Ave
Redding, CA 96002-2118

Phone

(530) 221-6584

Fax

(530) 221-8926

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Greg Gibson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Swell Endeavors Physical Therapy, Inc

  • Physical Therapist
  • Redding, CA
  • NPI 1750538336
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1073726139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990955",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960990955",
            "telephone_number": "530-243-2164",
            "fax_number": "530-243-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARTNELL AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022118",
            "telephone_number": "530-221-6584",
            "fax_number": "530-221-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PHILLIP",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "06982PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREG",
            "last_name": "GIBSON",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Casey Brian Gibbs, LPCC
• Curtis Allen Gibbs, BOARD CERTIFIED INST
• Brandon Michael Gibeau
• Maren Gibson
• Melissa Gibson
• Laurinda Gifford
• Orna Gil, MD
• Mary Frances Gilbert, LCSW
• Elijah Joseph Gildea, L.M.F.T.
• Bonnie Suzanne Giles

• Physical Therapist in Redding, CA
• Providers in Redding, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.