Individual provider Active NPI

Koskie Gibson

  • Occupational Therapist
  • Chapin, SC
National Provider Identifier
1225045503
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2672 Issued in SC
Practice address
130 Amicks Ferry Rd Ste G
Chapin, SC 29036-9400
Phone
(803) 932-2176
NPI assigned
Aug 1, 2006
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2672 SC Primary

Addresses

Primary practice location

130 Amicks Ferry Rd Ste G
Chapin, SC 29036-9400

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

105 Physicians Park Dr
Clinton, SC 29325-7551
Phone (864) 938-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061128000390 SC Practitioner - Occupational Therapist in Private Practice 7416955596 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

130 Amicks Ferry Rd
Suite G
Chapin, SC 29036-9400
Phone (803) 932-2176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2672SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy - South Carolina, LLC Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Benchmark Health Services Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Agilitas USA, Inc Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Palmetto Bone and Joint Occupational Therapist CurrentSince Jul 1, 2010 Accepting new patients
Benchmark Healthcare Services, LLC Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Agilitas USA Inc Occupational Therapist CurrentSince Oct 7, 2024 Accepting new patients
Ats Kids LLC Occupational Therapist PastSince Jun 3, 2025 Accepting new patients
Advanced Therapy Solutions, Inc. Occupational Therapist Past Accepting new patients
Advanced Therapy Solutions, Inc. Occupational Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

130 Amicks Ferry Rd
#G
Chapin, SC 29036
Phone (803) 932-2176

105 Physicians Park Dr
Clinton, SC 29325
Phone 864583005328

22971 Highway 76 E
Clinton, SC 29325
Phone (803) 833-3046

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

2704 Kinard St
Newberry, SC 29108
Phone (803) 321-6254

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1225045503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 AMICKS FERRY RD STE G",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290369400",
            "telephone_number": "803-932-2176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Physicians Park Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293257551",
            "country_code": "US",
            "telephone_number": "864-938-0111",
            "fax_number": "864-938-0811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KOSKIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.