Dwala Gibson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0083725 Issued in OK

Practice address

902 E Lincoln Rd
Idabel, OK 74745-7337

Phone

(580) 286-2600

Fax

(580) 286-1087

NPI assigned

May 14, 2015

Last updated

Sep 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Irene Benn Medical CenterGroup PAC ID 0840430724, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mesa View Regional Hospital Hospital, Mesquite, NV, CCN 291307

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Irene Benn Medical Center

  • Clinic/Center
  • Moapa, NV
  • NPI 1841535317

  TX

  Medicare reassignment Care Compare group NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Care

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment NPD
• DHHS IHS Phoenix Area

  dba Peach Springs Health Center

  • Clinic/Center
  • Peach Springs, AZ
  • NPI 1265719934

  TX

  Medicare reassignment NPD
• DHHS IHS Phoenix Area

  dba Chemehuevi Health Clinic

  • Federal Public Health Clinic/Center
  • Havasu Lake, CA
  • NPI 1396022026

  TX

  Medicare reassignment NPD
• Mashantucket Pequot Tribal Council

  • Family Medicine Physician
  • Ledyard, CT
  • NPI 1508140922

  TX

  Medicare reassignment NPD
• Choctaw Nation of Oklahoma

  dba Choctaw Nation Health Clinic - Broken Bow

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD
• DHHS IHS Phoenix

  dba Supai Health Center

  • Clinic/Center
  • Supai, AZ
  • NPI 1184901829
  NPD
• DHHS IHS Phoenix Area

  dba Parker Indian Hospital

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1851678585
  NPD

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

• MMC of Nevada LLC

  dba Mesa View Regional Hospital

  • Critical Access Hospital
  • Mesquite, NV
  • NPI 1275588782
  Care Compare affiliation

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1346628088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600",
            "fax_number": "580-286-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600",
            "fax_number": "580-286-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DWALA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0083725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Fulmer
• Kimberly Gaines, PHARM.D.
• Jana K Galloway, BA, BHRS
• Gary L Dennington DDS PC
• George Edward Freeman, D.O.,P.C.
• Rebecka Sue Goad
• Joshua M Golden, O.D.
• Jose J Gomez, MD
• Leticia Gonzalez
• Ramona Lynn Goolsby, APRN-CNP

• Family Nurse Practitioner in Idabel, OK
• Providers in Idabel, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.