Individual provider Active NPI

Sherri Jo Gibson, CNP

  • Family Nurse Practitioner
  • White, SD
National Provider Identifier
1487730347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R019223 Issued in SD
Practice address
302 East Fifth Street
White, SD 57276
Phone
(605) 629-8211
Fax
(605) 629-8291
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

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
Family Nurse Practitioner 363LF0000X R019223 SD Primary

Addresses

Primary practice location

302 East Fifth Street
White, SD 57276

Mailing address

302 East Fifth Street
White, SD 57276
Phone (605) 629-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20221031000648 SD Practitioner - Nurse Practitioner 4284804139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of BrookingsGroup PAC ID 1052307105, 112 clinicians

Practice addresses (Care Compare)

210 Kasan Ave
Volga, SD 57071-7701
Phone (605) 627-5701

302 E 5TH St
White, SD 57276-2061
Phone (605) 629-3333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R019223SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Brookings CurrentSince Jun 18, 2022 Accepting new patients
City of Brookings CurrentSince Jun 18, 2022 Accepting new patients
City of Brookings Current Accepting new patients
City of Brookings Current Accepting new patients

Locations

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

302 E 5th St
White, SD 57276
Phone (605) 629-8211

Interoperability endpoints

  • Direct secure messaging: sheri.gibson@avera.sdhealthlink.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487730347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 EAST FIFTH STREET",
            "city": "WHITE",
            "state": "SD",
            "postal_code": "57276",
            "telephone_number": "605-629-8211",
            "fax_number": "605-629-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 EAST FIFTH STREET",
            "city": "WHITE",
            "state": "SD",
            "postal_code": "57276",
            "telephone_number": "605-629-8211",
            "fax_number": "605-629-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHERRI",
        "middle_name": "JO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "R019223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White, SD

Sources for this page

Verify at the official NPI Registry.