Susan Diane Gibbs, PHARM D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH-00013608 Issued in OR

Practice address

5000 S 5TH Ave
Hines, IL 60141-3030

Phone

(253) 459-9087

Fax

(708) 202-8138

NPI assigned

Jul 29, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1497197602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 W 6TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982211232",
            "telephone_number": "408-623-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "253-459-9087",
            "fax_number": "708-202-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "SUSAN",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-00013608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale N. Gerding, M.D.
• Alan Ghannad
• Samaneh Ghassemi
• Jacquelyn Giaimo, LCSW
• Lisa Josephine Giannone, RD
• Jennifer L Gidd
• Krystal Lynn Marie Gilewski, M.S.W., LCSW
• Rachel Gill
• Courtney Jason Givens, PHARM.D.
• Robert Raymond Glon, R.PH.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Hines, IL
• Providers in Hines, IL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.