Active NPI
Amy Leigh Gibson
- Occupational Therapist
- Glen Allen, VA
National Provider Identifier
1447937362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119006206
- Practice address
- 12211 Kain Rd
Glen Allen, VA 23059-5720 - Phone
- (804) 519-8751
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119006206 | VA | Primary |
Addresses
Primary practice location
12211 Kain Rd
Glen Allen, VA 23059-5720
Mailing address
7717 Clarey LN
Mechanicsville, VA 23116-6707
Phone (804) 513-7458
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119006206 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1447937362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7717 CLAREY LN",
"city": "MECHANICSVILLE",
"state": "VA",
"postal_code": "231166707",
"telephone_number": "804-513-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12211 KAIN RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230595720",
"telephone_number": "804-519-8751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "AMY",
"middle_name": "LEIGH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119006206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.