Active NPI
Clarissa Gibson
- Day Training/Habilitation Specialist
- Cedartown, GA
National Provider Identifier
1275907438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- Practice address
- 424 N Main St
Cedartown, GA 30125-2644 - Phone
- (770) 749-2229
- NPI assigned
- Nov 25, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Day Training/Habilitation Specialist | 373H00000X | Primary |
Addresses
Primary practice location
424 N Main St
Cedartown, GA 30125-2644
Mailing address
424 N Main St
Cedartown, GA 30125-2644
Phone (770) 749-2229
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448409600000",
"number": "1275907438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 N MAIN ST",
"city": "CEDARTOWN",
"state": "GA",
"postal_code": "301252644",
"telephone_number": "770-749-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 N MAIN ST",
"city": "CEDARTOWN",
"state": "GA",
"postal_code": "301252644",
"telephone_number": "770-749-2229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "CLARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-25",
"last_updated": "2015-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedartown, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.