Patricia Gibson

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

CN0028836335 Issued in GA

Practice address

59 Tiffany Trace
Palmetto, GA 30268

Phone

(678) 541-7539

Fax

(678) 692-6562

NPI assigned

Jan 28, 2022

Last updated

Jan 29, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vivid Sky Home Care Services

  • Home Health Agency
  • Palmetto, GA
  • NPI 1841912037
  NPD Authorized official

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1407509524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90F GLENDA TRCE # 190",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302653858",
            "telephone_number": "678-541-7538",
            "fax_number": "678-692-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 TIFFANY TRACE",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "30268",
            "telephone_number": "678-541-7539",
            "fax_number": "678-692-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "CN0028836335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@vividskyhomecare.com",
            "affiliation": "N",
            "endpointDescription": "www.vividskyhomecare.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "59 Tiffany Trace",
            "city": "Palmetto",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jolyn Langford Garcia, PHARMD
• Miyoshi Garrison
• Gary L. Watts DMD PC
• Georgia Baptist Children's Homes and Family Ministries, Inc.
• Georgia Baptist Children's Homes and Family Ministries, Inc.
• Jennifer Marie Guinta
• H & J Home and Healthcare LLLP
• H&H III Inc. (All Pro Emergency Medical Services)
• Trina L. Hammonds, PH.D.
• Healthcare With Friends, LLC

• Home Health Agency in Palmetto, GA
• Providers in Palmetto, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; 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.