Active NPI
Roderick Gibbs
- Massage Therapist
- Daphne, AL
National Provider Identifier
1285009282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3627
- Practice address
- 1505 Daphne Ave
Daphne, AL 36526-4298 - Phone
- (251) 625-3178
- NPI assigned
- Dec 2, 2015
- Last updated
- Dec 2, 2015
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3627 | AL | Primary |
Addresses
Primary practice location
1505 Daphne Ave
Daphne, AL 36526-4298
Mailing address
25273 Spindle LN
Daphne, AL 36526-5419
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3627 | AL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baldwin Bone & Joint P C | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Daphne, AL
- NPI 1790714459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1285009282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25273 SPINDLE LN",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365265419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 DAPHNE AVE",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365264298",
"telephone_number": "251-625-3178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "RODERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AL",
"license": "3627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daphne, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.