Individual provider Active NPI

Anna Marie Gibson, CFNP

  • Family Nurse Practitioner
  • Proctorville, OH
National Provider Identifier
1194766295
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
54213 Issued in WV
Practice address
7718 County Road 107
Proctorville, OH 45669-7928
Phone
(740) 886-1150
Fax
(740) 886-1177
NPI assigned
Jun 9, 2006
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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 54213 WV Primary

Addresses

Primary practice location

7718 County Road 107
Proctorville, OH 45669-7928

Mailing address

7718 County Road 107
Proctorville, OH 45669-7928
Phone (740) 886-1150

Other identifiers 3

IdentifierTypeStateIssuer
2561286MedicaidOH
P00174864OtherWVRAILROAD MEDICARE
7102183000MedicaidWV

Other names 1

  • Anna Marie Perry Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anna.gibson@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200427002083 OH Practitioner - Nurse Practitioner 5698741007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7718 County Rd
Suite 107
Proctorville, OH 45669-7928
Phone (704) 886-1150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince May 4, 2020 Accepting new patients
University Physicians & Surgeons, Inc Family CurrentSince May 4, 2020 Accepting new patients
St. Mary's Himg, LLC Past Accepting new patients
Bradley J Richardson MD Ed D Inc Past Accepting new patients

Locations

7718 County Road 107
Proctorville, OH 45669
Phone (704) 886-1150

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

Interoperability endpoints

  • Direct secure messaging: anna.gibson@marshall.cernerdirect.com

Organizations & group practices 4

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.

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1194766295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7718 COUNTY ROAD 107",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456697928",
            "telephone_number": "740-886-1150",
            "fax_number": "740-886-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7718 COUNTY ROAD 107",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456697928",
            "telephone_number": "740-886-1150",
            "fax_number": "740-886-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "54213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2561286",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00174864",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102183000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anna.gibson@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "7718 County Road 107",
            "city": "Proctorville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456697928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "PERRY",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Proctorville, OH

Sources for this page

Verify at the official NPI Registry.