Individual provider Active NPI

Dawn Smith Gibbs, LMSW

  • Clinical Social Worker
  • Hixson, TN
National Provider Identifier
1366023400
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7792 Issued in TN
Practice address
809 N Valleywood Cir
Hixson, TN 37343-2448
Phone
(423) 314-7768
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11251 TN
Clinical Social Worker 1041C0700X 7792 TN Primary

Addresses

Primary practice location

809 N Valleywood Cir
Hixson, TN 37343-2448

Mailing address

809 N Valleywood Cir
Hixson, TN 37343-2448
Phone (423) 314-7768

Other practice location 1

6727 Heritage Business Ct
Chattanooga, TN 37421-7015
Phone (423) 314-7768

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

LicenseStateTypeSpecialty
7792TNMDClinical Social Worker
11251TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Intentional Healing Empowerment Center, LLC Clinical CurrentSince Apr 25, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1366023400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N VALLEYWOOD CIR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373432448",
            "telephone_number": "423-314-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N VALLEYWOOD CIR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373432448",
            "telephone_number": "423-314-7768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6727 Heritage Business Ct",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374217015",
            "country_code": "US",
            "telephone_number": "423-314-7768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH GIBBS",
        "first_name": "DAWN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "11251",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.