Individual provider Active NPI

Kathe Gibboney, FNP

  • Family Nurse Practitioner
  • Redwood City, CA
National Provider Identifier
1275860470
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
FNP4509 Issued in CA
Practice address
143 Birch St
Redwood City, CA 94062
Phone
(650) 366-1141
Fax
(650) 366-1265
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X FNP4509 CA Primary

Addresses

Primary practice location

143 Birch St
Redwood City, CA 94062

Mailing address

143 Birch St
Redwood City, CA 94062
Phone (650) 366-1141

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
FNP4509CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Street Medical Associates Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1275860470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 BIRCH ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94062",
            "telephone_number": "650-366-1141",
            "fax_number": "650-366-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 BIRCH ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94062",
            "telephone_number": "650-366-1141",
            "fax_number": "650-366-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONEY",
        "first_name": "KATHE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "FNP4509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.