Active NPI
Kent Douglas Gibson, L.I.S.W.
- School Social Worker
- Rio Rancho, NM
National Provider Identifier
1386861375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- I-3997
- Practice address
- 1500Veranda Dr. SE
Rio Rancho, NM 87124-3897 - Phone
- (505) 994-0229
- NPI assigned
- Apr 19, 2007
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | I-3997 | NM | Primary |
Addresses
Primary practice location
1500Veranda Dr. SE
Rio Rancho, NM 87124-3897
Mailing address
3704 Arboleda Senda, NE
Albuquerque, NM 87111
Phone (505) 275-3134
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-3997 | NM | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386861375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3704 ARBOLEDA SENDA, NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87111",
"telephone_number": "505-275-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500VERANDA DR. SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871243897",
"telephone_number": "505-994-0229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "KENT",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "L.I.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": "I-3997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- 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.