Active NPI
Michael L. Gibson, F.N.P.
- Nurse Practitioner
- Hayfork, CA
National Provider Identifier
1376774034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 18917
- Practice address
- 6961 Highway 3
Hayfork, CA 96041-6961 - Phone
- (530) 628-5517
- Fax
- (530) 628-5524
- NPI assigned
- Jul 29, 2009
- Last updated
- Jul 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18917 | CA | Primary |
Addresses
Primary practice location
6961 Highway 3
Hayfork, CA 96041-6961
Mailing address
PO Box 220
Hayfork, CA 96041-0220
Phone (530) 628-5517
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18917 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248825600000",
"number": "1376774034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 220",
"city": "HAYFORK",
"state": "CA",
"postal_code": "960410220",
"telephone_number": "530-628-5517",
"fax_number": "530-628-5524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6961 HIGHWAY 3",
"city": "HAYFORK",
"state": "CA",
"postal_code": "960416961",
"telephone_number": "530-628-5517",
"fax_number": "530-628-5524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "MICHAEL",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "F.N.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-29",
"last_updated": "2009-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "18917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayfork, CA
- Macy Marie Belongia, C BIRTH DOULA
- Donald E. Krouse, M.D. Inc (Hayfork Health Center)
- Allis Raelyn Fielding
- Gerald Reichelderfer (Hayfork Drugstore)
- Daniel Lee Humphrey
- Mountain Communities Healthcare District (Hayfork Community Health Clinic)
- Mountain Meadow Speech Therapy
- Deidre Leann Pickett, MA, CCC-SLP
- Holly Nicole Przybylowski, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.