Active NPI
Brian Adam Gibby, OT
- Occupational Therapist
- Orem, UT
National Provider Identifier
1134217904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 59303064201
- Practice address
- 527 W 400 N
Orem, UT 84057-1916 - Phone
- (801) 714-3505
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 59303064201 | UT | Primary |
Addresses
Primary practice location
527 W 400 N
Orem, UT 84057-1916
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 314-5220
Other practice location 1
1952 East 7000 S
#100
Salt Lake City, UT 84121
Phone (801) 942-3311 ext. 104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D6147 | Medicaid | UT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59303064201 | UT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1134217904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180",
"telephone_number": "801-314-5220",
"fax_number": "801-314-5221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 W 400 N",
"city": "OREM",
"state": "UT",
"postal_code": "840571916",
"telephone_number": "801-714-3505"
}
],
"practiceLocations": [
{
"address_1": "1952 East 7000 S",
"address_2": "#100",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "84121",
"country_code": "US",
"telephone_number": "801-942-3311 x104",
"fax_number": "801-943-3989",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBBY",
"first_name": "BRIAN",
"middle_name": "ADAM",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "UT",
"license": "59303064201",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D6147",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.