Individual provider Active NPI

Sheryl Ann Gibson

  • Addiction (Substance Use Disorder) Counselor
  • Corbin, KY
National Provider Identifier
1174018352
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1203 American Greeting Card Rd
Corbin, KY 40701-4811
Phone
(606) 528-4010
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1203 American Greeting Card Rd
Corbin, KY 40701-4811

Mailing address

800 Old Corbin Pike Rd
Williamsburg, KY 40769-2095
Phone (606) 515-2595

Other identifiers 1

IdentifierTypeStateIssuer
30613038MedicaidKY

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

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1174018352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OLD CORBIN PIKE RD",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407692095",
            "telephone_number": "606-515-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 AMERICAN GREETING CARD RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014811",
            "telephone_number": "606-528-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHERYL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30613038",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.