Heidi R Gibbons, C.R.N.P.

Key facts

NPI

1477615946

Entity type

Individual (NPI type 1)

Primary specialty

Adult Health Nurse Practitioner 363LA2200X

License

VP003820C (PA)

Practice address

1650 Huntingdon Pike
Suite 156
Meadowbrook, PA 19046-8004

Phone

(215) 947-7924

Fax

(215) 947-0187

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Montgomery County Medical Associates, LTD. Internal Medicine Physician · Meadowbrook, PA · NPI 1871530618
  Medicare reassignment NPD PA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIDBBA

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 21, 2016.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1477615946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HUNTINGDON PIKE",
            "address_2": "SUITE 156",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468004",
            "telephone_number": "215-947-7924",
            "fax_number": "215-947-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HUNTINGDON PIKE",
            "address_2": "SUITE 156",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468004",
            "telephone_number": "215-947-7924",
            "fax_number": "215-947-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "HEIDI",
        "middle_name": "R",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "VP003820C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE",
            "identifier": "500005396",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Meadowbrook, PA · Adult Health Nurse Practitioner in Pennsylvania