Active NPI
Jerry Winfield Gibbs, M.D.
- Emergency Medicine Physician
- Winter Haven, FL
National Provider Identifier
1235119470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME44690
- Practice address
- 200 Avenue F NE
Winter Haven Hospital
Winter Haven, FL 33881-4131 - Phone
- (863) 292-4202
- Fax
- (863) 292-4103
- NPI assigned
- Jan 21, 2006
- Last updated
- Dec 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME44690 | FL | Primary |
Addresses
Primary practice location
200 Avenue F NE
Winter Haven Hospital
Winter Haven, FL 33881-4131
Mailing address
PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3660
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME44690 | FL | MD | Emergency Medicine Physician |
| 44690 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196553600000",
"number": "1235119470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"address_2": "UFJP PROVIDER ENROLLMENT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008",
"telephone_number": "904-244-3660",
"fax_number": "904-244-3425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 AVENUE F NE",
"address_2": "WINTER HAVEN HOSPITAL",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814131",
"telephone_number": "863-292-4202",
"fax_number": "863-292-4103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "JERRY",
"middle_name": "WINFIELD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-21",
"last_updated": "2007-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME44690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.