Gracie Noel Gibson I

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

45023393A Issued in IN

Practice address

2100 Gardiner LN
Louisville, KY 40205-2962

Phone

(502) 413-8640

NPI assigned

Aug 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1689405953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11385 S OLD BEAR CREEK RD",
            "city": "PEKIN",
            "state": "IN",
            "postal_code": "471658622",
            "telephone_number": "812-987-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GARDINER LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052962",
            "telephone_number": "502-413-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "GRACIE",
        "middle_name": "NOEL",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "45023393A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Marie Gibson
• Anna L Gibson
• Brent Cameron Gibson, DPT
• Charles Gibson, RBT
• Elayna Brooke Gibson, PA-C
• Joy Gibson
• Madison Gibson, OD
• Makenna Brianne Gibson, DMD
• Marcus A Gibson, DMD
• Melissa Ann Gibson, PSYD

• Student in an Organized Health Care Education/Training Program in Louisville, KY
• Providers in Louisville, KY by specialty
• Student in an Organized Health Care Education/Training Program in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.