Individual provider Active NPI

Lindsay Roebuck- Gibson

  • Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1407376551
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009592 Issued in NC
Practice address
511 Paladin Dr
Greenville, NC 27834-7826
Phone
(252) 752-8880
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009592 NC
Nurse Practitioner 363L00000X 5009592 NC Primary

Addresses

Primary practice location

511 Paladin Dr
Greenville, NC 27834-7826

Mailing address

511 Paladin Dr
Greenville, NC 27834-7826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170828000502 NC Practitioner - Nurse Practitioner 8729350657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Nephrology Associates PLLCGroup PAC ID 2264420512, 75 clinicians

Practice addresses (Care Compare)

511 Paladin Dr
Greenville, NC 27834-7826
Phone (252) 752-8880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009592NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Nephrology Associates PLLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

511 Paladin Dr
Greenville, NC 27834
Phone (252) 317-2280

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: lgibsonroebuck70664@direct.acumenmd.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1407376551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PALADIN DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PALADIN DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347826",
            "telephone_number": "252-752-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK- GIBSON",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009592",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.