Mark Gibson, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

POR276 Issued in FL

Practice address

3334 Capital Medical Blvd #400
Tallahassee, FL 32308-4470

Phone

(850) 877-8174

Fax

(850) 877-5636

NPI assigned

Feb 10, 2014

Last updated

Nov 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1619391802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD #400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD #400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARK",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "FL",
            "license": "POR276",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "FL",
            "license": "POR276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951939400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Giampaolo French, ATC, LAT
• Karen Shirley Gibbons, LMHC
• Mandy A Gibbs, OT
• Janet Gibson, DO
• Lataeria Gibson
• Rhonda Gibson, LMHC
• Yolanda D Gibson, APRN
• Anquette Giddens
• Joseph Vincent Gigante, DDS
• Carol Giguere, O.D.

• Prosthetist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Prosthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.