Jarred Nathanial Gibson, MS, ATC, C.PED

Primary specialty

PedorthistTaxonomy code 224L00000X

Practice address

1310 Coburg Rd Ste 7
Eugene, OR 97401-5200

Phone

(541) 654-9447

Fax

(541) 972-2018

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Pinnacle Orthotics, LLC

  • Customized Equipment (DME)
  • Eugene, OR
  • NPI 1639650054

  Single Specialty

  NPD Authorized official
• Willamette Hand Therapy, LLC

  • Hand Occupational Therapist
  • Eugene, OR
  • NPI 1962727545

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1518920495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 COBURG RD STE 7",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015200",
            "telephone_number": "541-654-9447",
            "fax_number": "541-972-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 COBURG RD STE 7",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015200",
            "telephone_number": "541-654-9447",
            "fax_number": "541-972-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JARRED",
        "middle_name": "NATHANIAL",
        "name_prefix": "Mr.",
        "credential": "MS, ATC, C.PED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-730880",
            "primary": false
        },
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Grace Giandalia, PEER SUPPORT SPECIAL
• Kimberly Giansante
• Chelsea Dawn Gibbs
• Misty Gibbs, LMT
• Robyn Susan Gibbs, LCSW
• Lainey Nichole Gibson
• Marion K Gibson, ATC
• Shawn Marie Gibson, QMHP
• Brenton Gicker, EMT-I, RN
• Emma Corrine Gietzen, PSS

• Pedorthist in Eugene, OR
• Providers in Eugene, OR by specialty
• Pedorthist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.

Verify at the official NPI Registry.