Active NPI
Madison Alexandria Gibbs
- Behavior Technician
- Ridgeland, MS
National Provider Identifier
1295458362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 402B Legacy Park # 402B
Ridgeland, MS 39157-4315 - Phone
- (769) 233-7154
- NPI assigned
- Sep 22, 2022
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
402B Legacy Park # 402B
Ridgeland, MS 39157-4315
Mailing address
Legacy Park, 402 B
402 B
Ridgeland, MS 39157
Phone (769) 233-7154
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Sky Behavior Therapy | Current | Accepting new patients |
Locations
402B Legacy Park
Ridgeland, MS 39157
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 and National Provider Directory roles.
-
- Behavior Analyst
- Ridgeland, MS
- NPI 1609418896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1295458362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LEGACY PARK, 402 B",
"address_2": "402 B",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "39157",
"telephone_number": "769-233-7154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402B LEGACY PARK # 402B",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391574315",
"telephone_number": "769-233-7154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "MADISON",
"middle_name": "ALEXANDRIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2022-09-22",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.