NPIMap

Individual provider Active NPI

Carla Diane Gibbs, PA-C

  • Physician Assistant
  • Victoria, TX
National Provider Identifier
1346563145
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06556 Issued in TX
Practice address
2701 Hospital Dr
Victoria, TX 77901-5748
Phone
(361) 573-9181
Fax
(361) 572-5126
NPI assigned
Mar 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06556 TX Primary

Addresses

Primary practice location

2701 Hospital Dr
Victoria, TX 77901-5748

Mailing address

2701 Hospital Dr
Victoria, TX 77901-5748
Phone (361) 573-9181

Other identifiers 3

IdentifierTypeStateIssuer
213213601MedicaidTX
8L26631OtherTXMEDICARE PTAN
821N72OtherTXBLUE CROSS

Other names 1

  • Carla Diane Couch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000416 TX Practitioner - Physician Assistant 3173651320 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

18951 N Memorial Dr
Humble, TX 77338-4217
Phone (281) 319-8409

2600 Saint Michael Dr
Texarkana, TX 75503-5220
Phone (903) 614-5110

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 725-0000

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • Covenant Health Hobbs Hospital Hospital, Hobbs, NM, CCN 320065
  • Covenant Hospital Plainview Hospital, Plainview, TX, CCN 450539
  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305
  • Cogdell Memorial Hospital Hospital, Snyder, TX, CCN 451384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06556TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians of Texas I, Inc CurrentSince Feb 8, 2020 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc CurrentSince Feb 8, 2020 Accepting new patients

Locations

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1346563145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-573-9181",
            "fax_number": "361-572-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-573-9181",
            "fax_number": "361-572-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "CARLA",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213213601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8L26631",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "821N72",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "COUCH",
            "middle_name": "DIANE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.