Individual provider Active NPI

Kaleb Joseph Gibbs, FNP-BC

  • Family Nurse Practitioner
  • Henderson, NC
National Provider Identifier
1245712157
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010955 Issued in NC
Practice address
566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone
(252) 438-4143
NPI assigned
Sep 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5010955 NC Primary
Family Nurse Practitioner 363LF0000X 343305 NY

Addresses

Primary practice location

566 Ruin Creek Rd
Henderson, NC 27536-2927

Mailing address

359 Tremont Ave
Kenmore, NY 14217-2237
Phone (716) 485-1116

Other practice location 1

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone (919) 784-7093

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgibbs603689@direct.UNC.nchie.net Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181119000146 NC Practitioner - Nurse Practitioner 2769736354 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (984) 215-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010955NCMDFamily Nurse Practitioner
343305NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group North Carolina CurrentSince Sep 15, 2018 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 6, 2023 Accepting new patients
North Carolina MG, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

850 S Main St
Holly Springs, NC 27540
Phone (919) 784-7093

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: kgibbs603689@direct.unc.nchie.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1245712157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 TREMONT AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172237",
            "telephone_number": "716-485-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362927",
            "telephone_number": "252-438-4143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-7093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "KALEB",
        "middle_name": "JOSEPH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010955",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgibbs603689@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4420 Lake Boone Trl",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.