Active NPI
Kimberly Gibson
- Professional Counselor
- Las Vegas, NV
National Provider Identifier
1548325012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CI0010
- Practice address
- 4588 N Rancho Dr
Suite 12
Las Vegas, NV 89130-3426 - Phone
- (702) 396-3464
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 06-05AE-PL | AR | |
| Professional Counselor | 101YP2500X | CI0010 | NV | Primary |
Addresses
Primary practice location
4588 N Rancho Dr
Suite 12
Las Vegas, NV 89130-3426
Mailing address
PO Box 572238
Las Vegas, NV 89157-2238
Phone (702) 338-4034
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06-05AE-PL | AR | MD | Counselor |
| CI0010 | NV | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254873600000",
"number": "1548325012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 572238",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891572238",
"telephone_number": "702-338-4034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4588 N RANCHO DR",
"address_2": "SUITE 12",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891303426",
"telephone_number": "702-396-3464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2009-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AR",
"license": "06-05AE-PL",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NV",
"license": "CI0010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.