Individual provider Active NPI

Tavonie Michelle Ford-Gibbons, ARNP

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1215264171
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6222P Issued in KY
Practice address
716 W Broadway
Louisville, KY 40202-2216
Phone
(502) 595-7744
Fax
(502) 595-7007
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6222P KY Primary

Addresses

Primary practice location

716 W Broadway
Louisville, KY 40202-2216

Mailing address

716 W Broadway
Louisville, KY 40202-2216
Phone (502) 238-9911

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

State licenses

LicenseStateTypeSpecialty
6222PKYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1215264171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022216",
            "telephone_number": "502-238-9911",
            "fax_number": "502-238-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022216",
            "telephone_number": "502-595-7744",
            "fax_number": "502-595-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD-GIBBONS",
        "first_name": "TAVONIE",
        "middle_name": "MICHELLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "6222P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.