Individual provider Active NPI

Melissa Marie Gibblets, MS, OTRL

  • Occupational Therapist
  • Honesdale, PA
National Provider Identifier
1568580462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC007144L Issued in PA
Practice address
23 Ellen Memorial LN
Honesdale, PA 18431-4096
Phone
(570) 253-5690
NPI assigned
Mar 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC007144L PA Primary

Addresses

Primary practice location

23 Ellen Memorial LN
Honesdale, PA 18431-4096

Mailing address

47 Market St
Jenkins Township, PA 18640-1401
Phone (570) 655-1884

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Feb 10, 2020 Accepting new patients
Prime Rehabilitation Services, Inc. Occupational Therapist CurrentSince May 30, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Feb 10, 2020 Accepting new patients

Locations

8 John Walsh Blvd
Ste 406A
Peekskill, NY 10566
Phone (732) 440-7858

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568580462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MARKET ST",
            "city": "JENKINS TOWNSHIP",
            "state": "PA",
            "postal_code": "186401401",
            "telephone_number": "570-655-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ELLEN MEMORIAL LN",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184314096",
            "telephone_number": "570-253-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBLETS",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MS, OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC007144L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.