Jordan Thomas Gibson, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC015766 Issued in PA

Practice address

6 Garden Center Dr
Greensburg, PA 15601-1351

Phone

(814) 421-4805

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

Yes

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 PA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLC 600 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Bala Cynwyd, PA
  • NPI 1629885686

  Occupational Therapist, PA

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1407519952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GARDEN CENTER DR",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156011351",
            "telephone_number": "814-421-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GARDEN CENTER DR",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156011351",
            "telephone_number": "814-421-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JORDAN",
        "middle_name": "THOMAS",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC015766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Giallourakis, ATC
• Giant Eagle Inc
• Giant Eagle Long Term Care, LLC
• Giant Eagle, Inc
• Giant Eagle, Inc.
• Leslie Suzanne Gibson, OD
• Margaret Gibson, CACD, LPC
• Sieara L Gibson, MA
• Joseph Gigandet, MASTER LVL THERAPIST
• Lindsay Nicole Gilarski, M.S., ATC, LAT

• All providers in Greensburg, PA
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.