Active NPI
Pamela R Gibbons, ATC
- Athletic Trainer
- Orange, CA
National Provider Identifier
1285811935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1 University Dr
Orange, CA 92866-1005 - Phone
- (714) 997-6640
- Fax
- (714) 744-2161
- NPI assigned
- Jan 24, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1 University Dr
Orange, CA 92866-1005
Mailing address
1 University Dr
Orange, CA 92866-1005
Phone (714) 997-6640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 860020 | Other | NATA |
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": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201132800000",
"number": "1285811935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 UNIVERSITY DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928661005",
"telephone_number": "714-997-6640",
"fax_number": "714-744-2161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 UNIVERSITY DR",
"city": "ORANGE",
"state": "CA",
"postal_code": "928661005",
"telephone_number": "714-997-6640",
"fax_number": "714-744-2161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "PAMELA",
"middle_name": "R",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2008-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA",
"identifier": "860020",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.