Organization Active NPI

Gibson Psych Services

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Eden Prairie, MN
National Provider Identifier
1255023982
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
Legal business name
GIBSON PSYCH SERVICES
Practice address
11800 Singletree LN Ste 312
Eden Prairie, MN 55344-5398
Phone
(612) 440-6557
Fax
(612) 500-4964
NPI assigned
May 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Joan GibsonNPI 1518916071
Title
Aprn, Psychiatric CNS
Phone
(612) 242-9532

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X Primary

Addresses

Primary practice location

11800 Singletree LN Ste 312
Eden Prairie, MN 55344-5398

Mailing address

11800 Singletree LN Ste 312
Eden Prairie, MN 55344-5398
Phone (612) 440-6557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230706001294 MN Part B Supplier - Clinic/Group Practice 8325407596 Receives reassigned benefits from 1 practitioner
Practice locations: Eden Prairie, MN

National Provider Directory

National Provider Directory

Locations

11800 Singletree Ln
Ste 312
Eden Prairie, MN 55344
Phone (612) 440-6557

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1255023982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 SINGLETREE LN STE 312",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445398",
            "telephone_number": "612-440-6557",
            "fax_number": "612-500-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SINGLETREE LN STE 312",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445398",
            "telephone_number": "612-440-6557",
            "fax_number": "612-500-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON PSYCH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "APRN, PSYCHIATRIC CNS",
        "authorized_official_telephone_number": "612-242-9532"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.