Individual provider Active NPI

Rhonda Lamar Gibson, ACNP

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1114270030
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
17515 Issued in SC
Practice address
147 Fox Squirrel Cir
Columbia, SC 29209-4478
Phone
(803) 543-9401
NPI assigned
Oct 16, 2012
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 17515 SC Primary

Addresses

Primary practice location

147 Fox Squirrel Cir
Columbia, SC 29209-4478

Mailing address

9900 Bren Road East
Mail Route MN 008-B213
Minnetonka, MN 55343
Phone (803) 543-9401

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rhonda.gibson@optum.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20210331001681 SC Practitioner - Nurse Practitioner 8527475995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bogan Sleep ConsultantsGroup PAC ID 0143507285, 6 clinicians

Practice addresses (Care Compare)

1333 Taylor St
Suite 6B
Columbia, SC 29201-2953
Phone (803) 251-3093

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17515SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bogan Sleep Consultants CurrentSince Jan 16, 2024 Accepting new patients
Palmetto Orthopaedic Clinic, PA PastSince Jan 1, 2004 Accepting new patients

Locations

1333 Taylor St
Ste 6B
Columbia, SC 29201
Phone (803) 251-3093

Interoperability endpoints

  • Direct secure messaging: bogansleepconsultants.rhondagibson@146601.advancedmd-direct.com
  • Direct secure messaging: rhonda.gibson@optum.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1114270030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN ROAD EAST",
            "address_2": "MAIL ROUTE MN 008-B213",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "803-543-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 FOX SQUIRREL CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292094478",
            "telephone_number": "803-543-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RHONDA",
        "middle_name": "LAMAR",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "17515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhonda.gibson@optum.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "147 Fox Squirrel Cir",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292094478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.