Individual provider Active NPI

Christian Philip Gibbs, DNP, FNP-C

  • Family Nurse Practitioner
  • Buford, GA
National Provider Identifier
1467065433
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN264422 Issued in GA
Practice address
2800 Buford Dr Ste 110
Buford, GA 30519-5107
Phone
(470) 236-4085
Fax
(470) 323-9177
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN264422 GA Primary

Addresses

Primary practice location

2800 Buford Dr Ste 110
Buford, GA 30519-5107

Mailing address

4015 Hedgemoore CT
Cumming, GA 30041-9453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230510002759 GA Practitioner - Nurse Practitioner 6406212885 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN264422GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oconee Family Practice, PC CurrentSince Feb 2, 2023 Accepting new patients
Family Practice Center, P.C. CurrentSince Oct 13, 2024 Accepting new patients

Locations

2800 Buford Dr
Ste 110
Buford, GA 30519
Phone (470) 236-4085

1747 Langford Dr
Bldg 400-105
Watkinsville, GA 30677
Phone (706) 769-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1467065433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 HEDGEMOORE CT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BUFORD DR STE 110",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305195107",
            "telephone_number": "470-236-4085",
            "fax_number": "470-323-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "CHRISTIAN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN264422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.