Individual provider Active NPI

Carley Renee Gibson

  • Family Nurse Practitioner
  • Petrolia, PA
National Provider Identifier
1194602854
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP033871 Issued in PA
Practice address
296 Church St
Petrolia, PA 16050-3006
Phone
(724) 756-2940
Fax
(724) 756-8515
NPI assigned
Aug 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP033871 PA Primary

Addresses

Primary practice location

296 Church St
Petrolia, PA 16050-3006

Mailing address

100 Shenango Ave
Sharon, PA 16146-1503
Phone (724) 756-2940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013002576 PA Practitioner - Nurse Practitioner 2466949607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health NetworkGroup PAC ID 9234046228, 64 clinicians

Practice addresses (Care Compare)

296 Church St
Petrolia, PA 16050-3006
Phone (724) 756-2940

419 Kellys Way
East Brady, PA 16028-0368
Phone (724) 526-5600

Hospital & facility affiliations

  • Independence Health System Butler Memorial Hospita Hospital, Butler, PA, CCN 390168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP033871PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince Sep 23, 2025 Accepting new patients
Primary Health Network CurrentSince Sep 23, 2025 Accepting new patients
Primary Health Network Past Accepting new patients

Locations

30 Pinnacle Dr
Clarion, PA 16214
Phone (814) 223-9900

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

100 Shenango Ave
Sharon, PA 16146
Phone (724) 704-8886

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1755302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1194602854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "724-756-2940",
            "fax_number": "724-756-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 CHURCH ST",
            "city": "PETROLIA",
            "state": "PA",
            "postal_code": "160503006",
            "telephone_number": "724-756-2940",
            "fax_number": "724-756-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CARLEY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-16",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petrolia, PA

Sources for this page

Verify at the official NPI Registry.