Individual provider Active NPI

Hannah Rose Wilson Gibbs, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1649889932
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3014805 Issued in KY
Practice address
200 Oceangate
Long Beach, CA 90802-4302
Phone
(598) 413-8904
NPI assigned
Jul 23, 2020
Last updated
Dec 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404041 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0030321 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11938-33 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61288327 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3014805 KY Primary

Addresses

Primary practice location

200 Oceangate
Long Beach, CA 90802-4302

Mailing address

200 Oceangate
Long Beach, CA 90802-4302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220519001854 WI Practitioner - Nurse Practitioner 6406272764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of New York, Inc. CurrentSince Jul 19, 2022 Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince May 18, 2022 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

5232 Witz Dr
North Syracuse, NY 13212
Phone (315) 632-5960

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

Interoperability endpoints

  • Direct secure messaging: hgibbs12884@direct-prd.molinahealthcare.com

Organizations & group practices 4

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1649889932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024302",
            "telephone_number": "598-413-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "HANNAH",
        "middle_name": "ROSE WILSON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404041",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0030321",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "11938-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61288327",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3014805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.