Individual provider Active NPI

Laurie E. Gibbons, C.N.M.

  • Advanced Practice Midwife
  • Boca Raton, FL
National Provider Identifier
1497150296
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
ARNP1805962 Issued in FL
Practice address
6853 SW 18TH St
Boca Raton, FL 33433-7060
Phone
(561) 368-3775
Fax
(561) 368-1143
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X ARNP1805962 FL Primary

Addresses

Primary practice location

6853 SW 18TH St
Boca Raton, FL 33433-7060

Mailing address

6853 SW 18TH St
Boca Raton, FL 33433-7060
Phone (561) 368-3775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010003352 FL Practitioner - Certified Nurse Midwife (CNM) 5496100539 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1805962FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC CurrentSince Jul 24, 2023 Accepting new patients

Locations

6859 SW 18th St
Ste 200
Boca Raton, FL 33433
Phone (561) 368-3775

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

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.

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1497150296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 SW 18TH ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334337060",
            "telephone_number": "561-368-3775",
            "fax_number": "561-368-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6853 SW 18TH ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334337060",
            "telephone_number": "561-368-3775",
            "fax_number": "561-368-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "LAURIE",
        "middle_name": "E.",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP1805962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.