Individual provider Active NPI

Cheryl Strube Gibbons, RN

  • School Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1477688117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN079708 Issued in AZ
Practice address
35 W Dunlap Ave
Phoenix, AZ 85021-3523
Phone
(623) 915-8763
Fax
(623) 915-8762
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN079708 AZ Primary

Addresses

Primary practice location

35 W Dunlap Ave
Phoenix, AZ 85021-3523

Mailing address

35 W Dunlap Ave
Phoenix, AZ 85021-3523
Phone (623) 915-8763

Other identifiers 1

IdentifierTypeStateIssuer
RN079708OtherAZREG NURSE LICENSE

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN079708AZMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477688117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850213523",
            "telephone_number": "623-915-8763",
            "fax_number": "623-915-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850213523",
            "telephone_number": "623-915-8763",
            "fax_number": "623-915-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "CHERYL",
        "middle_name": "STRUBE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN079708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REG NURSE LICENSE",
            "identifier": "RN079708",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.