Individual provider Active NPI

Jennifer Nicole Gibeson, RN

  • School Registered Nurse
  • Rio Rancho, NM
National Provider Identifier
1609594969
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
114261 Issued in KS
Practice address
500 Laser Rd NE
Rio Rancho, NM 87124-4517
Phone
(505) 962-1242
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 114261 KS Primary

Addresses

Primary practice location

500 Laser Rd NE
Rio Rancho, NM 87124-4517

Mailing address

500 Laser Rd NE
Rio Rancho, NM 87124-4517
Phone (505) 962-1242

Other names 1

  • Jennifer Selgelid Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
114261KSMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rio Rancho Public Schools PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1609594969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LASER RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244517",
            "telephone_number": "505-962-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LASER RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244517",
            "telephone_number": "505-962-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBESON",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "KS",
            "license": "114261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SELGELID",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.