Active NPI
Shelli Gibbs
- Family Nurse Practitioner
- Ladson, SC
National Provider Identifier
1336697846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20314
- Practice address
- 267 Treeland Dr
Suite C
Ladson, SC 29456-3083 - Phone
- (843) 277-2240
- NPI assigned
- Sep 13, 2016
- Last updated
- Sep 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 20314 | SC | Primary |
Addresses
Primary practice location
267 Treeland Dr
Suite C
Ladson, SC 29456-3083
Mailing address
267 Treeland Dr
Suite C
Ladson, SC 29456-3083
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20314 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473724800000",
"number": "1336697846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 TREELAND DR",
"address_2": "SUITE C",
"city": "LADSON",
"state": "SC",
"postal_code": "294563083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 TREELAND DR",
"address_2": "SUITE C",
"city": "LADSON",
"state": "SC",
"postal_code": "294563083",
"telephone_number": "843-277-2240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "SHELLI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-13",
"last_updated": "2016-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "20314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ladson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.