Kathleen K Gibbons, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

26530 Issued in GA

Practice address

6131 S Norcross Tucker Rd
Ste 700
Norcross, GA 30093-5536

Phone

(678) 205-1959

Fax

(678) 205-2092

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1306865951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 KENDALL STA NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301027962",
            "telephone_number": "770-974-4314",
            "fax_number": "678-421-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 S NORCROSS TUCKER RD",
            "address_2": "STE 700",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300935536",
            "telephone_number": "678-205-1959",
            "fax_number": "678-205-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "KATHLEEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "026530",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "26530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000639834Z",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Physician Associates PC
• Georgia Physician Associates PC
• Georgia Primary Care
• Get Well Recovery Center, LLC
• Douha Ghazal
• Nona R Giddens
• Michelle Lawrimore Gillespie, LPC
• Erin Gish, PT, DPT
• Ca Trice B. Glenn, LPC, NCC
• Salma Glili

• Pediatrics Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.