Jessica N Gibson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

005483 Issued in KY

Practice address

105 Windsor Path Ste 1
Georgetown
Georgetown, KY 40324-9617

Phone

(502) 570-2337

Fax

(502) 570-2338

NPI assigned

Apr 4, 2014

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 identifiers 2

Other names 1

• Ms. Jessica N Sturdivant Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Kentucky, LLCGroup PAC ID 1850729211, 108 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Empowerme Rehabilitation Kentucky, LLC

  • Multi-Specialty Clinic/Center
  • Lexington, KY
  • NPI 1275166696

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation Kentucky, LLC

  • Rehabilitation Clinic/Center
  • Florence, KY
  • NPI 1669195640
  NPD

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1124446364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 STURBRIDGE DR",
            "address_2": "GEORGETOWN",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403242536",
            "telephone_number": "606-424-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WINDSOR PATH STE 1",
            "address_2": "GEORGETOWN",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249617",
            "telephone_number": "502-570-2337",
            "fax_number": "502-570-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JESSICA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000869196",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100300660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STURDIVANT",
            "middle_name": "N",
            "prefix": "MS.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Georgetown Urgent Care PLLC
• Georgetown-Scott County Ambulance Service
• Gerogetown Community Hospital LLC
• Anne-Claire Gibson, RBT
• Heath Martin Gibson, PA-C
• Stacee Marie Gibson, ATC
• Dudley Brewer Glass, Jr., D.M.D.
• Dustin Michael Golebieski, DPT
• Michael Goodwin, D.O.
• Shon L Goodwin, M.S.

• Physical Therapist in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.