Patrice I Gibson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5660 Issued in TN

Practice address

303 Med Tech Pkwy Ste 100
Johnson City, TN 37604

Phone

(423) 282-5611

Fax

(423) 282-5712

NPI assigned

Jul 27, 2006

Last updated

Mar 31, 2021By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Specialists of Johnson City

  • Endocrinology, Diabetes & Metabolism Physician
  • Johnson City, TN
  • NPI 1083931539
  NPD (past)
• State of Franklin Healthcare Associates PLLC

  • Clinical Medical Laboratory
  • Johnson City, TN
  • NPI 1841846136
  NPD (past)
• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1184638116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3889",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023889",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Med Tech Pkwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37604",
            "country_code": "US",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Med Tech Pkwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37604",
            "country_code": "US",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PATRICE",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "5660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017051",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01703629",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Gibson
• Jennifer Diane Gibson, M.D.
• Martha Fay Gibson, DPH
• Mary J Gibson, MD
• Nathan Gibson
• Victoria Gibson, DPT
• Eve Giesey, LPCC
• Abigail Gilbert
• Anna Broome Gilbert, M.D.
• Danielle S Giles, NP

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.