Active NPI
Mark Gibbs
- Family Nurse Practitioner
- Gainesville, VA
National Provider Identifier
1306463930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024179511
- Practice address
- 7512 Gardner Park Dr
Gainesville, VA 20155-3414 - Phone
- (703) 753-9860
- NPI assigned
- Jun 30, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024179511 | VA | Primary |
Addresses
Primary practice location
7512 Gardner Park Dr
Gainesville, VA 20155-3414
Mailing address
7512 Gardner Park Dr
Gainesville, VA 20155-3414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7512 Gardner Park Dr
Gainesville, VA 20155-3414
Phone (703) 753-9860
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Promoting interoperability
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1306463930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7512 GARDNER PARK DR",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7512 GARDNER PARK DR",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201553414",
"telephone_number": "703-753-9860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-30",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024179511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.