Active NPI
Samantha Gibson, NP
- Family Nurse Practitioner
- Hartwell, GA
National Provider Identifier
1124806625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN279360
- Practice address
- 125 W Gibson St
Hartwell, GA 30643-1848 - Phone
- (706) 376-6131
- NPI assigned
- Sep 18, 2023
- Last updated
- Sep 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN279360 | GA | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | RN279360 | GA |
Addresses
Primary practice location
125 W Gibson St
Hartwell, GA 30643-1848
Mailing address
125 W Gibson St
Hartwell, GA 30643-1848
Phone (706) 376-6131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN279360 | GA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694995200000",
"number": "1124806625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W GIBSON ST",
"city": "HARTWELL",
"state": "GA",
"postal_code": "306431848",
"telephone_number": "706-376-6131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W GIBSON ST",
"city": "HARTWELL",
"state": "GA",
"postal_code": "306431848",
"telephone_number": "706-376-6131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "SAMANTHA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-18",
"last_updated": "2023-09-18",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN279360",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "GA",
"license": "RN279360",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartwell, GA
- Georgia Mountains Community Services
- Georgia Mountains Community Services
- Georgia Mountains Community Services
- Georgia Mountains Community Services
- Georgia Mountains Community Services
- Jennifer Glaze, R.N.
- Daniel Gordon, M.D.
- Sam C Grizzle, DDS
- Crystal Ashley Hamilton, LCSW
- Mouhammad Samer Hamwy, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.