Individual provider Active NPI

Dianna R Gibson, C.R.N.A

  • Certified Registered Nurse Anesthetist
  • Florence, OR
National Provider Identifier
1194099143
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
202010013CRNA Issued in OR
Practice address
400 9TH St
Florence, OR 97439-7398
Phone
(555) 555-5555
NPI assigned
Mar 7, 2012
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2012007166 MO
Certified Registered Nurse Anesthetist 367500000X APRN99562 WV
Certified Registered Nurse Anesthetist 367500000X R229632 MD
Certified Registered Nurse Anesthetist 367500000X 16886 TN
Certified Registered Nurse Anesthetist 367500000X 202010013CRNA OR Primary

Addresses

Primary practice location

400 9TH St
Florence, OR 97439-7398

Mailing address

400 9TH St
Florence, OR 97439-7398
Phone (555) 555-5555

Other practice location 1

1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgibson202105@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WV, OR, GU4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170524002869 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406017821 Reassigns benefits to 3 organizations
I20190110000100 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406017821 Reassigns benefits to 1 organization
I20201119003265 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406017821 Reassigns benefits to 1 organization
I20251203002159 GU Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406017821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ac Micro Guam LLCGroup PAC ID 9133021710, 4 clinicians

Practice addresses (Care Compare)

633 Gov Carlos Camacho Rd
Suite 101
Tamuning, GU 96931-3134
Phone (671) 646-3855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
16886TNMDClinical Social Worker
2012007166MOMDCertified Registered Nurse Anesthetist
APRN99562WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Group of Tennessee, P. C. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2012 Accepting new patients
Ba Ventures LLC CurrentSince Mar 17, 2024 Accepting new patients
Parkville Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 18, 2019 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2019 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2019 Accepting new patients
United Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2019 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Aug 1, 2019 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Aug 1, 2019 Accepting new patients
Ac Micro Guam LLC CurrentSince Aug 7, 2025 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

633 Gov Carlos G Camacho Rd
Ste 101
Tamuning, GU 96913
Phone (671) 646-3855

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

11085 Little Patuxent Pkwy
Bldg 4
Columbia, MD 21044
Phone (410) 730-0099

19 Fontana Ln
Ste 104
Rosedale, MD 21237
Phone (410) 574-7776

360 S Garden Way
Ste 100
Eugene, OR 97401
Phone (541) 334-0488

2435 NW Kline St
Roseburg, OR 97471
Phone (541) 672-2020

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

135 W Ravine Rd
Ste 5-B
Kingsport, TN 37660
Phone (423) 224-3460

3211 Dudley Ave
Parkersburg, WV 26104
Phone (304) 422-3904

601 Avery St
Ste 501
Parkersburg, WV 26101
Phone (304) 422-3904

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

Interoperability endpoints

  • Direct secure messaging: dgibson202105@samhealth.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1194099143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974397398",
            "telephone_number": "555-555-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974397398",
            "telephone_number": "555-555-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 6th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211916",
            "country_code": "US",
            "telephone_number": "541-812-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DIANNA",
        "middle_name": "R",
        "credential": "C.R.N.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2012007166",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "APRN99562",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R229632",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "16886",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "202010013CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgibson202105@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.