Individual provider Active NPI

Michael Gibbs, NP

  • Nurse Practitioner
  • Palm Beach Gardens, FL
National Provider Identifier
1336449206
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9319273 Issued in FL
Practice address
4290 Professional Center Dr
Palm Beach Gardens, FL 33410-4275
Phone
(561) 277-8493
NPI assigned
Oct 26, 2010
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X UP006080B PA
Nurse Practitioner 363L00000X ARNP9319273 FL Primary

Addresses

Primary practice location

4290 Professional Center Dr
Palm Beach Gardens, FL 33410-4275

Mailing address

135 Via Condado Way
Palm Beach Gardens, FL 33418-1703
Phone (561) 939-6340

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9319273FLMDNurse Practitioner
UP006080BPAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1336449206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 VIA CONDADO WAY",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334181703",
            "telephone_number": "561-939-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 PROFESSIONAL CENTER DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104275",
            "telephone_number": "561-277-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "UP006080B",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9319273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.