Active NPI
Jean Gibson
- Nurse Practitioner
- New York, NY
National Provider Identifier
1245697267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 43 430155
- Practice address
- 2091 Amsterdam Ave
New York, NY 10032 - Phone
- (917) 676-9148
- NPI assigned
- Jan 21, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 43 430155 | NY | Primary |
Addresses
Primary practice location
2091 Amsterdam Ave
New York, NY 10032
Mailing address
355 W 115 St
#2B
New York, NY 10026
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43 430155 | NY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1245697267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 W 115 ST",
"address_2": "#2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2091 AMSTERDAM AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10032",
"telephone_number": "917-676-9148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-21",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "43 430155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.