Individual provider Active NPI

Sarah L. Gibbons, CPNP

  • Pediatric Nurse Practitioner
  • Crystal City, TX
National Provider Identifier
1215187679
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP115374 Issued in TX
Practice address
1313 Veterans Avenue
Suite C
Crystal City, TX 78839-3724
Phone
(830) 374-4436
Fax
(830) 374-4437
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 578107 TX
Pediatric Nurse Practitioner 363LP0200X AP115374 TX Primary

Addresses

Primary practice location

1313 Veterans Avenue
Suite C
Crystal City, TX 78839-3724

Mailing address

403 S. 7TH Street
Carrizo Springs, TX 78834-4204
Phone (830) 876-9870

Other identifiers 1

IdentifierTypeStateIssuer
198469204MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
578107TXMDPediatric Nurse Practitioner
AP115374TXMDPediatric Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJHGCA/Endpoint/EJHGCA

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1215187679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 S. 7TH STREET",
            "city": "CARRIZO SPRINGS",
            "state": "TX",
            "postal_code": "788344204",
            "telephone_number": "830-876-9870",
            "fax_number": "830-876-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 VETERANS AVENUE",
            "address_2": "SUITE C",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393724",
            "telephone_number": "830-374-4436",
            "fax_number": "830-374-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "SARAH",
        "middle_name": "L.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "578107",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP115374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198469204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.