Karen Renee Gibbs Green

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

608423 Issued in TX

Practice address

11502 Yoakum St
Pearland, TX 77584-5711

Phone

(713) 303-3434

NPI assigned

Aug 26, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1376156695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11502 YOAKUM ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845711",
            "telephone_number": "713-303-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11502 YOAKUM ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845711",
            "telephone_number": "713-303-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS GREEN",
        "first_name": "KAREN",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "608423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSURE",
            "identifier": "608423",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "efax.com",
            "affiliation": "N",
            "endpointDescription": "encrypted",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "messaging",
            "address_1": "11502 Yoakum St",
            "city": "Pearland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775845711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Administrator Registered Nurse in Pearland, TX
• Providers in Pearland, TX by specialty
• Administrator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.