NPIMap

Organization Active NPI

Charles C. Gibson, O.D.P.a.

  • Optometrist
  • Fort Smith, AR
National Provider Identifier
1457632515
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2069 Issued in AR
Legal business name
CHARLES C. GIBSON, O.D.P.A.
Practice address
2425 S. Zero Street
Fort Smith, AR 72901
Phone
(479) 649-5900
Fax
(479) 649-6724
NPI assigned
Sep 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Dr. Charles C Gibson, O.D.P.A.
Title
President
Phone
(479) 649-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2069 AR Primary

Addresses

Primary practice location

2425 S. Zero Street
Fort Smith, AR 72901

Mailing address

2425 S. Zero Street
Fort Smith, AR 72901
Phone (479) 649-5900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1457632515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 S. ZERO STREET",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-649-5900",
            "fax_number": "479-649-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S. ZERO STREET",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-649-5900",
            "fax_number": "479-649-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES C. GIBSON, O.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-649-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D.P.A."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.