Reanna Gibbs, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00379500 Issued in NJ

Practice address

201 Bridgeton Pike
Mullica Hill, NJ 08062-2671

Phone

(856) 478-2111

Fax

(856) 478-4709

NPI assigned

Nov 5, 2015

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excelcare Alliance, LLC

  • Family Medicine Physician
  • Vineland, NJ
  • NPI 1891090510
  Medicare reassignment
• Dendrinos Medical Associates, P.a.

  • General Practice Physician
  • Vineland, NJ
  • NPI 1386839603
  NPD (past)
• Mullica Hill Medical Associates PC

  • Family Medicine Physician
  • Mullica Hill, NJ
  • NPI 1740381680
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1497128920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BRIDGETON PIKE",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622671",
            "telephone_number": "856-478-2111",
            "fax_number": "856-478-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BRIDGETON PIKE",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622671",
            "telephone_number": "856-478-2111",
            "fax_number": "856-478-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "REANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00379500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reanna.gibbs.2@12810.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "201 Bridgeton Pike",
            "city": "Mullica Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080622671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simone Gafitanu, DO
• Peter J Galiano, DO
• Sri Harshini Gandhamaneni, MBBS
• Miranda Gardina
• Camille Giancola, PT, DPT
• Jeffrey T Gibson, MD
• Stephanie Glanville, PSY.D.
• Thomas Cyril Glass, MD
• Hollie Glenwright
• Gloucester County Surgery Center, LLC

• Medical Physician Assistant in Mullica Hill, NJ
• Providers in Mullica Hill, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.