Individual provider Active NPI

Don Eugene Gibbons, PH.D.

  • Clinical Psychologist
  • Manahawkin, NJ
National Provider Identifier
1336192681
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100351300 Issued in NJ
Practice address
703 Mill Creek Rd Ste G1
Manahawkin, NJ 08050-3828
Phone
(609) 494-0009
Fax
(609) 660-2275
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35S100351300 NJ Primary

Addresses

Primary practice location

703 Mill Creek Rd Ste G1
Manahawkin, NJ 08050-3828

Mailing address

152 Brigantine Rd
Manahawkin, NJ 08050-1308
Phone (609) 494-0009

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35S100351300NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1336192681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BRIGANTINE RD",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080501308",
            "telephone_number": "609-494-0009",
            "fax_number": "609-660-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MILL CREEK RD STE G1",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503828",
            "telephone_number": "609-494-0009",
            "fax_number": "609-660-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "DON",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100351300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.