Individual provider Active NPI

Mercedes Jacqueline Gibbons, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1366877441
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11001149 Issued in FL
Practice address
321 W Oak St
Kissimmee, FL 34741-4421
Phone
(407) 647-1781
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11001149 FL Primary

Addresses

Primary practice location

321 W Oak St
Kissimmee, FL 34741-4421

Mailing address

321 W Oak St
Kissimmee, FL 34741-4421
Phone (833) 769-3524

Other practice location 1

3080 Park Pond Way
Kissimmee, FL 34741-7662
Phone (689) 305-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20200616000488 FL Practitioner - Nurse Practitioner 9335561695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians
Brave Health Inc.Group PAC ID 8123458981, 112 clinicians

Practice addresses (Care Compare)

321 W Oak St
Lifestance Health
Kissimmee, FL 34741-4421
Phone (407) 537-9452

3891 Bowfin TRL
Kissimmee, FL 34746-1957
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11001149FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Inc. CurrentSince Mar 6, 2021 Accepting new patients
Personal Recovery Network LLC CurrentSince May 1, 2020 Accepting new patients

Locations

321 W Oak St
Kissimmee, FL 34741
Phone (321) 594-5801

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: mercedes.gibbons.1@23300.direct.athenahealth.com
  • Direct secure messaging: fbh.mercedesgibbons@141363.advancedmd-direct.com

Organizations & group practices 2

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1366877441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414421",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414421",
            "telephone_number": "407-647-1781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3080 Park Pond Way",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347417662",
            "country_code": "US",
            "telephone_number": "689-305-2225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "MERCEDES",
        "middle_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11001149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.