NPIMap

Individual provider Active NPI

Eric Gibbs, PHARMD.

  • Pharmacist
  • Corbin, KY
National Provider Identifier
1255440806
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
54004437 MED Issued in KY
Practice address
40 Moonbow PLZ
Suite #1
Corbin, KY 40701-8982
Phone
(606) 258-0000
Fax
(606) 258-0002
NPI assigned
Aug 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 54004437 MED KY Primary
Pharmacist 183500000X 90006305 DME KY
Pharmacist 183500000X P06831 PHARMACY KY

Addresses

Primary practice location

40 Moonbow PLZ
Suite #1
Corbin, KY 40701-8982

Mailing address

40 Moonbow PLZ
Suite #1
Corbin, KY 40701-8982
Phone (606) 258-0000

Other names 1

  • Falls Road Pharmacy Other name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
54004437 MEDKYMDPharmacist
90006305 DMEKYMDPharmacist
P06831 PHARMACYKYMDPharmacist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255440806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MOONBOW PLZ",
            "address_2": "SUITE #1",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018982",
            "telephone_number": "606-258-0000",
            "fax_number": "606-258-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MOONBOW PLZ",
            "address_2": "SUITE #1",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018982",
            "telephone_number": "606-258-0000",
            "fax_number": "606-258-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "54004437 MED",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "90006305 DME",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "P06831 PHARMACY",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FALLS",
            "last_name": "PHARMACY",
            "middle_name": "ROAD",
            "credential": "PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.