Active NPI
John E. Gibbons, PH.D.
- Clinical Psychologist
- Severna Park, MD
National Provider Identifier
1487864807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 02253
- Practice address
- 8 Cypress Creek Rd
Severna Park, MD 21146-4050 - Phone
- (410) 544-8507
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 02253 | MD | Primary |
Addresses
Primary practice location
8 Cypress Creek Rd
Severna Park, MD 21146-4050
Mailing address
488 Lymington Rd
Severna Park, MD 21146-3548
Phone (410) 544-8507
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 - G463 - JE - 62 | Other | MD | BLUE CROSS - BLUE SHIELD |
| S094 - 0001 | Other | MD | GHMSI |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Services LLC | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- Arnold, MD
- NPI 1134483910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560643200000",
"number": "1487864807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 LYMINGTON RD",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211463548",
"telephone_number": "410-544-8507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 CYPRESS CREEK RD",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464050",
"telephone_number": "410-544-8507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "JOHN",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2019-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "02253",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS - BLUE SHIELD",
"identifier": "0 - G463 - JE - 62",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHMSI",
"identifier": "S094 - 0001",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.