Active NPI
Jonathan Gibbs
- Mental Health Counselor
- Shawnee, OK
National Provider Identifier
1255888426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1127 N Kickapoo Ave
Shawnee, OK 74801-4845 - Phone
- (405) 214-0116
- Fax
- (877) 334-8552
- NPI assigned
- Sep 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1127 N Kickapoo Ave
Shawnee, OK 74801-4845
Mailing address
1310 N Beard Ave
Shawnee, OK 74801-4910
Phone (405) 214-0116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240830001146 | OK | Practitioner - Mental Health Counselor | 6608315999 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473120000000",
"number": "1255888426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 N BEARD AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748014910",
"telephone_number": "405-214-0116",
"fax_number": "877-334-8552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 N KICKAPOO AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748014845",
"telephone_number": "405-214-0116",
"fax_number": "877-334-8552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-06",
"last_updated": "2016-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.