Active NPI
Philip Joseph Gibeau, PHD
- Clinical Psychologist
- Springfield, OH
National Provider Identifier
1144387820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2851
- Practice address
- 20 South Limestone St Ste 340
Springfield, OH 45502 - Phone
- (937) 325-3370
- Fax
- (937) 325-3432
- NPI assigned
- Jan 2, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2851 | OH | Primary |
Addresses
Primary practice location
20 South Limestone St Ste 340
Springfield, OH 45502
Mailing address
30 Kensington Place South
20 South Limestone St Ste 340
Springfield, OH 45504
Phone (937) 399-1026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0408115 | Medicaid | OH |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2851 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144387820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 KENSINGTON PLACE SOUTH",
"address_2": "20 SOUTH LIMESTONE ST STE 340",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "45504",
"telephone_number": "937-399-1026",
"fax_number": "937-325-3432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 SOUTH LIMESTONE ST STE 340",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "45502",
"telephone_number": "937-325-3370",
"fax_number": "937-325-3432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBEAU",
"first_name": "PHILIP",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "2851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0408115",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.