Radine A Gibson

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

048891 Issued in WV

Practice address

1 Stadium Drive
Morgantown, WV 26506

Phone

(304) 598-4800

Fax

(304) 293-6963

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in WV

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• West Virginia University Hospitals Inc

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1598847634
  Medicare reassignment NPD
• West Virginia University Medical Corporation

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment NPD
• West Virginia University Hospitals, Inc.

  • Rehabilitation Hospital Unit
  • Morgantown, WV
  • NPI 1760209225
  NPD
• West Virginia University Medical Corporation

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• West Virginia University Hospitals, Inc.

  • Emergency Medicine Physician
  • Uniontown, PA
  • NPI 1225693484
  NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083794150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-598-4800",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RADINE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "048891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167154000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giant Eagle Inc
• Giant Eagle Inc
• Audrey Elizabeth Gibb, MSW
• Holley Gibson
• Jason Gibson
• Ruth Gibson
• Audrey Giesler
• Morgan Elisha Gifford
• Lynne A Gilchrist
• Kristin Lea Giles, PA-C

• Pediatric Nurse Practitioner in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Pediatric Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.