Active NPI
Richard B Gibbons, ARNP
- Nurse Practitioner
- Lake City, FL
National Provider Identifier
1346207586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP1144982
- Practice address
- 1859 SW Newland Way
Lake City, FL 32025-6966 - Phone
- (386) 758-0003
- Fax
- (386) 755-7940
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1144982 | FL | Primary |
Addresses
Primary practice location
1859 SW Newland Way
Lake City, FL 32025-6966
Mailing address
1859 SW Newland Way
Lake City, FL 32025-6966
Phone (386) 758-0003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307264900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1144982 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1346207586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1859 SW NEWLAND WAY",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320256966",
"telephone_number": "386-758-0003",
"fax_number": "386-755-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1859 SW NEWLAND WAY",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320256966",
"telephone_number": "386-758-0003",
"fax_number": "386-755-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "RICHARD",
"middle_name": "B",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP1144982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "307264900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.