Melinda Faye Gibson, CRNP
Individual provider Active NPI Pediatric Nurse Practitioner · Greenville, AL
NPI 1104065267 · NPPES record last updated Feb 13, 2019
Key facts
- NPI
- 1104065267
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 1-069655 (AL)
- Practice address
- 300 N College St
Greenville, AL 36037-2025 - Phone
- (334) 382-2681
- Fax
- (334) 383-9884
- NPI assigned
- Feb 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190722003425 | AL | Practitioner - Nurse Practitioner | 8628304169 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LV Stabler Primary Care LLC | Current |
Accepting new patients | |
| Children'S Urgent Care, LLC | Current |
Accepting new patients | |
| Pediatric Rural Health Clinics, Inc | Pediatrics | Past | Accepting new patients |
Locations
500 Cahaba Park Cir
Ste 100
Birmingham, AL 35242
Phone (205) 848-2273
300 N College St
Greenville, AL 36037
Phone (334) 382-2681
117 N Chalkville Rd
Trussville, AL 35173
Phone (205) 848-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 1-069655 | AL | Yes |
Addresses
Primary practice location
300 N College St
Greenville, AL 36037-2025
Mailing address
46 L V Stabler Dr
Greenville, AL 36037-3865
Phone (334) 382-9760
Other practice location 1
46 L V Stabler Dr
Greenville, AL 36037-3865
Phone (334) 382-9760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51218738 | Other | AL | BCBS ALABAMA |
| 225930 | Medicaid | AL |
Other names
- Miss Melinda Faye Rogers
Other providers in Greenville, AL
- Amanda Gagliardi
- Gardner Eye Care LLC
- James Caleb Gardner
- Garlock Enterprises
- Setondji Gbegan
- Richard Giovane
- Tabitha Jean Gomillion
- Greenville Footcare LLC
- William Hamilton Jr.
- Hands of Standard LLC
All providers in Greenville, AL · Pediatric Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.