Active NPI
Lisa R Gibbs, AUD
- Audiologist
- Urbana, IL
National Provider Identifier
1285077578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147000511
- Practice address
- 611 W. Park St.
Audiology
Urbana, IL 61801-2500 - Phone
- (217) 383-3130
- NPI assigned
- Apr 17, 2013
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 147000511 | IL | Primary |
Addresses
Primary practice location
611 W. Park St.
Audiology
Urbana, IL 61801-2500
Mailing address
611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147000511 | IL | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Past | Accepting new patients |
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.
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- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1285077578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W. PARK ST.",
"address_2": "BWPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500",
"telephone_number": "217-383-6941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W. PARK ST.",
"address_2": "AUDIOLOGY",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500",
"telephone_number": "217-383-3130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "LISA",
"middle_name": "R",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-17",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147000511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.