Walter Frank Gibson, LPN

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

300562397 Issued in FL

Practice address

37 N Orange Ave
Suite 500
Orlando, FL 32801-2449

Phone

(407) 926-4124

Fax

(407) 926-4121

NPI assigned

Aug 2, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boulevard Operator LLC

  dba The Boulevard Post Acute

  • Skilled Nursing Facility
  • Fairfax, VA
  • NPI 1912791872
  NPD

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1548548928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 N ORANGE AVE",
            "address_2": "SUITE 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012449",
            "telephone_number": "407-926-4124",
            "fax_number": "407-926-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N ORANGE AVE",
            "address_2": "SUITE 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012449",
            "telephone_number": "407-926-4124",
            "fax_number": "407-926-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WALTER",
        "middle_name": "FRANK",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "300562397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Ann Gibson
• Permelia Kaye Gibson
• Regina Dibella Gibson, MSW
• Sarah R. Gibson, MD
• Symone Gibson, LCSW
• Samuel Abraham Giday, M.D.
• Megan Elizabeth Giddens, MSW, LCSW
• Kerry Ann Giedd, OD, MS
• Adreana Marcella Giehl
• Jose Ismael Gierbolini, M.D.

• In Home Supportive Care Agency in Orlando, FL
• Providers in Orlando, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.