Individual provider Active NPI

Patricia D Gibbons, ANP

  • Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1265458285
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LB0000174 Issued in DE
Practice address
501 West 14TH Street
Wilmington, DE 19801-1013
Phone
(302) 733-5625
Fax
(302) 478-7002
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X LB0000174 DE
Nurse Practitioner 363L00000X LB0000174 DE Primary

Addresses

Primary practice location

501 West 14TH Street
Wilmington, DE 19801-1013

Mailing address

200 Hygeia Drive
Suite 2300
Newark, DE 19713-2049

Other names 1

  • Patricia D Hall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20051012001080 DE Practitioner - Nurse Practitioner 2163447756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine Pain Consultants PAGroup PAC ID 2567487150, 5 clinicians

Practice addresses (Care Compare)

5311 Limestone Rd
Suite 100
Wilmington, DE 19808-1257
Phone (302) 234-2200

774 Christiana Rd
Suite 111
Newark, DE 19713-4248
Phone (302) 478-7001

774 Christiana Rd
Suite 202
Newark, DE 19713-4221
Phone (302) 478-7001

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LB0000174DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine Pain Consultants, PA CurrentSince Oct 1, 2004 Accepting new patients
Anesthesia Group Practice, Inc Past Accepting new patients

Locations

774 Christiana Rd
Ste 111
Newark, DE 19713
Phone (302) 478-7001

3411 Silverside Rd
Ste 103
Wilmington, DE 19810
Phone (302) 479-8464

Interoperability endpoints

  • Direct secure messaging: interventionalspinepainconsultantspa.patriciagibbons@146264.advancedmd-direct.com

Organizations & group practices 2

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 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1265458285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WEST 14TH STREET",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011013",
            "telephone_number": "302-733-5625",
            "fax_number": "302-478-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "PATRICIA",
        "middle_name": "D",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "DE",
            "license": "LB0000174",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LB0000174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "HALL",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.