Jacqueline Gibbons

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

3799 Cape Landing Cir Apt C
Myrtle Beach, SC 29588-1123

Phone

(845) 313-2012

NPI assigned

Apr 10, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orange County Ahrc

  • Early Intervention Provider Agency
  • New Windsor, NY
  • NPI 1699902676
  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1144663089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3799 CAPE LANDING CIR APT C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295881123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3799 CAPE LANDING CIR APT C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295881123",
            "telephone_number": "845-313-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1145 Little Britain Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "New Windsor",
            "state": "NY",
            "postal_code": "125535980",
            "country_code": "US",
            "telephone_number": "845-564-1855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Shaniece Gerald, PA-C
• Amanda Brooke Germer
• Get Mobile Physical Therapy LLC
• Anita D Giardino, OT
• Erica Leanne Gibbons, DO
• Brittany Gibbs, SSP, LPES, RN
• Jevaughn Gibbs, OD
• Sean L. Gibbs, M.D.
• Troy Gibson
• Valda Gibson, M.D.

• Occupational Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.