Individual provider Active NPI

Cindy Gibson, CCC-SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1174779763
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8040 Issued in NC
Practice address
8402 Six Forks Rd Ste 104
Raleigh, NC 27615-3071
Phone
(919) 847-6773
Fax
(919) 847-6827
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8040 NC Primary

Addresses

Primary practice location

8402 Six Forks Rd Ste 104
Raleigh, NC 27615-3071

Mailing address

8402 Six Forks Rd Ste 104
Raleigh, NC 27615-3071
Phone (919) 847-6773

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

LicenseStateTypeSpecialty
8040NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1174779763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 SIX FORKS RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153071",
            "telephone_number": "919-847-6773",
            "fax_number": "919-847-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 SIX FORKS RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153071",
            "telephone_number": "919-847-6773",
            "fax_number": "919-847-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CINDY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.