Active NPI
Mary Evelyn Gibbs, M.A., CCC-SLP
- Speech-Language Pathologist
- Fayetteville, AR
National Provider Identifier
1285880146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#1204
- Practice address
- 1000 W Stone St
Fayetteville, AR 72701-5653 - Phone
- (479) 444-3000
- NPI assigned
- Aug 12, 2008
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#1204 | AR | Primary |
Addresses
Primary practice location
1000 W Stone St
Fayetteville, AR 72701-5653
Mailing address
14225 Skyview East Rd
West Fork, AR 72774-2928
Phone (479) 846-5936
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#1204 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1285880146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14225 SKYVIEW EAST RD",
"city": "WEST FORK",
"state": "AR",
"postal_code": "727742928",
"telephone_number": "479-846-5936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W STONE ST",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727015653",
"telephone_number": "479-444-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "MARY",
"middle_name": "EVELYN",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-12",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.