Jesse Graham Gibbons, AA-C

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2011032476 Issued in MO

Practice address

3635 Vista
St. Louis, MO 63110

Phone

(314) 577-8000

NPI assigned

Oct 20, 2011

Last updated

Oct 20, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Anesthesia Providers SCGroup PAC ID 9830480581, 180 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts, Physician Assistant

State licenses

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.

• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1245515295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 MARK DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443135842",
            "telephone_number": "216-372-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-577-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JESSE",
        "middle_name": "GRAHAM",
        "name_prefix": "Mr.",
        "credential": "AA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2011032476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Gianoli, PA-C, MMS,ATC-L, MAT
• Briana Gibb, RN
• Kristen N Gibbar
• Erin Anne Gibbons, MD
• James J Gibbons, M.D.
• Laura Grace Gibbons
• Marquee Christine Gibbons, RD, LDN
• Briana Michelle Gibbs, WHNP
• Brittney Chanel Gibbs, MA
• Cynthia Ann Gibbs, SPEECH PATHOLOGIST

• Anesthesiologist Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiologist Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.