Devona J Gibbs, FNP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

064033 Issued in MO

Practice address

196 Timber Ridge TRL
Poplar Bluff, MO 63901-1595

Phone

(573) 686-4133

Fax

(573) 778-1099

NPI assigned

Jan 4, 2006

Last updated

Aug 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• BHG Lxxiv, LLC

  dba BHG Medical Services - Missouri

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Springfield, MO
  • NPI 1982315230
  Medicare reassignment NPD
• BHG Xliii, LLC

  dba BHG Northern Springfield Treatment Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Springfield, MO
  • NPI 1558805754
  Medicare reassignment NPD
• Bhgxxix, LLC

  dba BHG Poplar Bluff Treatment Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Poplar Bluff, MO
  • NPI 1508277229
  Medicare reassignment NPD
• DRD Management, Inc

  dba BHG Springfield Treatment Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Springfield, MO
  • NPI 1134380405
  Medicare reassignment NPD
• Vcphcs XV, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Joplin, MO
  • NPI 1144666264
  Medicare reassignment NPD
• BHG Lxxiv, LLC

  dba BHG Medical Services - Missouri

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Joplin, MO
  • NPI 1437860772
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1215915889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 TIMBER RIDGE TRL",
            "address_2": "ROOM 205",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011595",
            "telephone_number": "573-778-2888",
            "fax_number": "877-610-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 TIMBER RIDGE TRL",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011595",
            "telephone_number": "573-686-4133",
            "fax_number": "573-778-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "DEVONA",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MO",
            "license": "064033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428182034",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133802758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "500000980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George F. Blaich, DMD & Associates, PC (Dental Arts Group)
• Cliff George
• Alexandros Georgolios, MD
• Matthew Douglas Geyer, PSY.D.
• Gibbs Wound Care LLC
• James William Gieselmann, MD
• Gilbert D. Smith, M.D., LLC
• Gilbert D. Smith, MD, LLC
• Anderson Mark Gilberto, DDS
• Patty Taylor Gilberto, AUD

• Critical Care Medicine Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Critical Care Medicine Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.