Brad Gibson, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0029637 Issued in OH

Practice address

10552 Success LN Ste L
Centerville, OH 45458-3664

Phone

(937) 280-5711

NPI assigned

Aug 28, 2020

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beacon St. Psychiatry

  dba A Life Renewed

  • Psychiatric/Mental Health Nurse Practitioner
  • Centerville, OH
  • NPI 1780460006
  Medicare reassignment NPD Authorized official
• Crestview Mental Health of Ohio, LLC

  dba Mason Family Counseling

  • Adult Mental Health Clinic/Center
  • Mason, OH
  • NPI 1235850405
  Medicare reassignment NPD
• WS Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
  • NPI 1225710668
  NPD
• Lee Side Wellness Associates, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mason, OH
  • NPI 1841731510
  NPD (past)

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1205449261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10552 SUCCESS LN STE L",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583664",
            "telephone_number": "937-280-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10552 SUCCESS LN STE L",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583664",
            "telephone_number": "937-280-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BRAD",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brad@alrhealth.com",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10552 Success Ln Ste L",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454583664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dick A. Genardi, PH.D.
• Lamar Kohoutek Gerber, PHARMD
• German Burke Orthodontics, Inc. (GB Orthodontics)
• Get Centered Counseling & Consultation LLC
• Tameka Shantae Gibbs
• Jacob B Gibson, DO
• Katherine S Gilmore, CNP
• Karen M Gisslen, CNM
• Alexis Paola Gleghorn
• Jeffrey B Gleick, MD

• Psychiatric/Mental Health Nurse Practitioner in Centerville, OH
• Providers in Centerville, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.