Angel S Gibson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5174 Issued in SC

Practice address

1925 Essex Farms Dr
Charleston, SC 29414-6696

Phone

(843) 779-1685

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Charleston OT LLC

  • Occupational Therapist
  • Charleston, SC
  • NPI 1144679655
  NPD (past)
• Charleston St LLC

  • Speech-Language Pathologist
  • Charleston, SC
  • NPI 1629777511
  NPD (past)

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1093409674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 FLYWAY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294838021",
            "telephone_number": "803-316-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ESSEX FARMS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146696",
            "telephone_number": "843-779-1685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 Flyway Rd",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294838021",
            "country_code": "US",
            "telephone_number": "803-316-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ANGEL",
        "middle_name": "S",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "5174",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otto Tremond Gibbs, MD
• Tracy Gibbs
• Sallie Clark Giblin, MD
• Victoria Giblin
• Barry Gibney, D.O.
• Britton Ashley Gibson, MD, MPH
• Taylor Leigh Gibson
• Tung N Giep, M.D.
• Sarah Thomas Giff, PH.D.
• Christopher R Gilbert, D.O.

• Occupational Therapy Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.