Jessica Elizabeth Gibson, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#2586 Issued in AR

Practice address

1600 Riverfront Dr
Little Rock, AR 72202

Phone

(501) 663-6965

Fax

(501) 603-0675

NPI assigned

Apr 29, 2008

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1417122649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 AVIGNON CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239104",
            "telephone_number": "501-351-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 RIVERFRONT DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72202",
            "telephone_number": "501-663-6965",
            "fax_number": "501-603-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#2586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "113694335",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168616721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gibson Sales LP (Drug Emporium #240)
• Alexandra Gibson
• Anna Marie Gibson, RN
• Gary G. Gibson, PD
• Gunnar H Gibson, MD
• Katie G Gibson, DDS
• Lora Rebecca Gibson, OTR/L
• Melinda Gibson, CRNA
• Mitzi A Gibson, MSPT
• Patricia Lynne Gibson, M.D.

• Speech-Language Pathologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.