Individual provider Active NPI

Laura Isabel Gibson, MS, CCC-SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1093236689
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA6717 Issued in FL
Practice address
7975 Lake Underhill Rd Ste 300
Orlando, FL 32822-8205
Phone
(407) 303-6733
Fax
(407) 303-6715
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA6717 FL Primary

Addresses

Primary practice location

7975 Lake Underhill Rd Ste 300
Orlando, FL 32822-8205

Mailing address

932 Palm Cove Dr
Orlando, FL 32835-8050
Phone (407) 808-8942

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA6717FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1093236689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 PALM COVE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328358050",
            "telephone_number": "407-808-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228205",
            "telephone_number": "407-303-6733",
            "fax_number": "407-303-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LAURA",
        "middle_name": "ISABEL",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; 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.