Individual provider Active NPI

Nicole Gibbs

  • Occupational Therapist
  • Athens, GA
National Provider Identifier
1194408815
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1021 Parkway Blvd Ste 101
Athens, GA 30606-6189
Phone
(706) 352-2448
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

1021 Parkway Blvd Ste 101
Athens, GA 30606-6189

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230831003728 GA Practitioner - Occupational Therapist in Private Practice 8921461369 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1021 Pkwy Blvd
Suite 101
Athens, GA 30606-6189
Phone (706) 352-2448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jan 11, 2026 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Aug 14, 2023 Accepting new patients
Benchmark Physical Therapy Inc Occupational Therapist CurrentSince Jan 11, 2026 Accepting new patients
Agilitas USA, Inc Occupational Therapist CurrentSince Jan 11, 2026 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Aug 14, 2023 Accepting new patients
Agilitas USA Inc Occupational Therapist CurrentSince Jan 11, 2026 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12850 Highway 9 N
Ste 1050
Alpharetta, GA 30004
Phone (678) 332-5800

1021 Parkway Blvd
Ste 101
Athens, GA 30606
Phone (706) 352-2448

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

3919 Carter Rd
#A
Buford, GA 30518
Phone (470) 589-1058

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

1498 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 289-0525

Organizations & group practices 6

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": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1194408815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 PARKWAY BLVD STE 101",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066189",
            "telephone_number": "706-352-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.