Emily Gibson, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0028533 Issued in OH

Practice address

675 Justice Way Room C0049
Indianapolis, IN 46203

Phone

(877) 465-6650

Fax

(804) 294-2775

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, UT2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Holon Health Great Lakes, P.C.

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1194414805

  IN

  Medicare reassignment NPD
• Holon Health Professional Corp

  • Addiction Medicine (Preventive Medicine) Physician
  • Springfield, IL
  • NPI 1821971912

  UT

  Medicare reassignment NPD
• Holon Health, Inc.

  • Addiction Medicine (Preventive Medicine) Physician
  • Elizabethtown, KY
  • NPI 1942902093
  NPD (past)

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1407438146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E MAIN ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473744208",
            "telephone_number": "765-973-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 JUSTICE WAY ROOM C0049",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46203",
            "telephone_number": "877-465-6650",
            "fax_number": "804-294-2775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 E Main St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473744208",
            "country_code": "US",
            "telephone_number": "765-973-9294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Gibson, CPT
• Asia Patrice Gibson
• Autumn Gibson
• Daniel Gibson, MD
• Deana Gibson, RBT
• Jennifer Gibson
• Joseph Gibson
• Kaitlin Marie Gibson
• Michelle Nicole Gibson, AGAC-NP
• Monica Prasad Gibson, BDS, PHD, MS, FRCDC

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.