Individual provider Active NPI

Karen Lynn Gibble, APRN, BC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Wilmington, DE
National Provider Identifier
1619910775
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
LE-0000158 Issued in DE
Practice address
604 Milltown Rd
Wilmington, DE 19808-2227
Phone
(888) 517-2088
Fax
(302) 998-3242
NPI assigned
Jun 14, 2006
Last updated
Mar 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X LE-0000158 DE Primary

Addresses

Primary practice location

604 Milltown Rd
Wilmington, DE 19808-2227

Mailing address

604 Milltown Rd
Wilmington, DE 19808-2227
Phone (888) 517-2088

Other identifiers 1

IdentifierTypeStateIssuer
1000025177MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000792 DE Practitioner - Certified Clinical Nurse Specialist (CNS) 8628036142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
LE-0000158DEMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Treatment Options, LLC Psychiatric/Mental Health CurrentSince Jan 1, 2008 Accepting new patients
A Center for Human Development LTD PastSince Jan 19, 2006 Accepting new patients

Locations

1601 Milltown Rd
Ste 22
Wilmington, DE 19808
Phone (302) 897-4942

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1619910775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MILLTOWN RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198082227",
            "telephone_number": "888-517-2088",
            "fax_number": "302-998-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MILLTOWN RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198082227",
            "telephone_number": "888-517-2088",
            "fax_number": "302-998-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBLE",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "DE",
            "license": "LE-0000158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000025177",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.