Caron Gibson Henderson, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R873868 Issued in MS

Practice address

1616 Williams Dr
Leakesville, MS 39451-5622

Phone

(601) 394-2381

Fax

(601) 394-5715

NPI assigned

Aug 31, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Caron Cathleen Gibson Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WCS Professional Services of Mississippi, LLCGroup PAC ID 3476790502, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke Home Health Services Home health agency, McComb, MS, CCN 257124
• Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
• Lawrence County Hospital Cah Hospital, Monticello, MS, CCN 251305
• Tyler Holmes Memorial Hospital Cah Hospital, Winona, MS, CCN 251312

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4

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.

• WCS Professional Services of Mississippi, LLC

  • Nurse Practitioner
  • Metairie, LA
  • NPI 1265785455

  MS

  Medicare reassignment Care Compare group NPD
• FGH Trauma Surgery Clinic

  • Surgery Physician
  • Hattiesburg, MS
  • NPI 1427090398

  MS

  Medicare reassignment NPD
• Outreach Health Services,Inc.

  • Community Health Clinic/Center
  • Shubuta, MS
  • NPI 1548359565

  MS

  Medicare reassignment NPD
• Pioneer Health Care , LLC

  • General Practice Physician
  • Bassfield, MS
  • NPI 1336384742

  MS

  Medicare reassignment NPD
• Restorixhealth at-Home, LLC

  • Nurse Practitioner
  • Metairie, LA
  • NPI 1255974689

  MS

  Medicare reassignment NPD
• Outreach Health Services,Inc.

  • Health Maintenance Organization
  • Heidelberg, MS
  • NPI 1255521480
  NPD
• Coastal Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Leakesville, MS
  • NPI 1801999479
  NPD (past)
• Conx Care Corporation

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1548183510
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Mississippi Home Health, Inc. - Region I

  • Home Health Agency
  • Laurel, MS
  • NPI 1326039470
  Care Compare affiliation
• Southwest Mississippi Regional Medical Center

  • Critical Access Hospital
  • Monticello, MS
  • NPI 1932211851

  Hospital

  Care Compare affiliation
• St. Luke Home Health Services, LLC

  • Home Health Agency
  • McComb, MS
  • NPI 1255401642
  Care Compare affiliation
• Tyler Holmes Memorial Hospital

  • Critical Access Hospital
  • Winona, MS
  • NPI 1205868627

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1316253115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394510160",
            "telephone_number": "601-394-2381",
            "fax_number": "601-394-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 WILLIAMS DR",
            "city": "LEAKESVILLE",
            "state": "MS",
            "postal_code": "394515622",
            "telephone_number": "601-394-2381",
            "fax_number": "601-394-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CARON",
        "middle_name": "GIBSON",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R873868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09228250",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARON",
            "last_name": "GIBSON",
            "middle_name": "CATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Leakesville, MS
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.

Verify at the official NPI Registry.