Eric Keven Gibson, NO

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4301 Buffalo TRL
Evans, CO 80620-9454

Phone

(310) 877-0774

NPI assigned

Mar 7, 2019

Last updated

Mar 7, 2019By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1114485257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 BUFFALO TRL",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806209454",
            "telephone_number": "310-877-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 BUFFALO TRL",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806209454",
            "telephone_number": "310-877-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ERIC",
        "middle_name": "KEVEN",
        "credential": "NO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2137347793",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dallas Katelynn Frisbie
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• Victoria M Gerber, LPC
• Glee Frances Gile, PA-C
• Godpath Ministries, Inc.
• Alexis Ramses Gomez Mendoza, PHARMD
• Libby Goode-Grasmick, DC
• Grayco,Inc. (Gray Cara West)

• Mental Health Counselor in Evans, CO
• Providers in Evans, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.