Katherine Woody Gibson, MA,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5525 Issued in FL

Practice address

3775 Cricket Cove Rd E
Jacksonville, FL 32224-8401

Phone

(904) 254-0337

Fax

(904) 223-4368

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Gibson of Jax, Inc.

  • Developmental Therapist
  • Jacksonville, FL
  • NPI 1831422112

  Speech-Language Pathologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356441828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 CRICKET COVE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248401",
            "telephone_number": "904-821-2063",
            "fax_number": "904-223-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 CRICKET COVE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248401",
            "telephone_number": "904-254-0337",
            "fax_number": "904-223-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KATHERINE",
        "middle_name": "WOODY",
        "name_prefix": "Mrs.",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Aneice Gibson, APRN, FNP-BC
• Deborah Denise Gibson, APRN
• Deveni Gibson
• Elizabeth Margaret Gibson, MHCI
• Fred Lloyd Gibson IV, DC
• Loren Gibson
• Mollie Gibson, QASP
• Neil William Carlton Gibson, MD
• Shamara Gibson, LCSW
• Tammeza Gibson, PA

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.