Stephanie Lewis Gibson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LL35801 Issued in SC

Practice address

9 Richland Medical Park Dr
Columbia, SC 29203-6859

Phone

(803) 434-6455

NPI assigned

Nov 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Abigail Lewis Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430

  Pediatrics

  Medicare reassignment NPD
• Eau Claire Cooperative Health Center ,Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD
• Prisma Health-Midlands

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1154373843
  NPD (past)
• Prisma Health-Midlands

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1558576280
  NPD (past)

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1124356399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR STE 320",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036845",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-6455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N 12th St",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291696502",
            "country_code": "US",
            "telephone_number": "803-217-0415",
            "fax_number": "803-939-1650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "STEPHANIE",
        "middle_name": "LEWIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2021-04-01",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL35801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "LEWIS",
            "middle_name": "ABIGAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob Gibson
• Lindsey Gibson
• Melinda D. Gibson, CRNA
• Rhonda Lamar Gibson, ACNP
• Sarah Elaine Gibson, RBT
• Tacquetta Myrtelle Gibson
• Taneisha Sierra Gibson
• Donald R Gidney, LISW-CP, LCSW, LCAS
• Jan H. Giesen, LISW-CP
• Robert Richard Murrray Gifford, M.D.

• Pediatrics Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.