Individual provider Active NPI

Wanda Marea Gibson-Scipio, FNP-BC

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1689877649
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704123322 Issued in MI
Practice address
5285 Anthony Wayne Dr
Detroit, MI 48202-3947
Phone
(313) 577-5041
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704123322 MI Primary

Addresses

Primary practice location

5285 Anthony Wayne Dr
Detroit, MI 48202-3947

Mailing address

5285 Anthony Wayne Dr
Detroit, MI 48202-3947
Phone (313) 577-5041

Other names 1

  • Wanda Marea Gibson-Scipio Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071101000222 MI Practitioner - Nurse Practitioner 3971690355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nursing Practice CorporationGroup PAC ID 5395746143, 3 clinicians

Practice addresses (Care Compare)

1550 Taylor St
Detroit, MI 48206-2081
Phone (313) 486-5501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nursing Practice Corporation CurrentSince Jan 13, 2021 Accepting new patients
Nursing Practice Corporation CurrentSince Jan 13, 2021 Accepting new patients

Locations

1550 Taylor St
Detroit, MI 48206
Phone (313) 486-5501

5285 Anthony Wayne Dr
Detroit, MI 48202
Phone (313) 577-5041

Interoperability endpoints

  • Direct secure messaging: gibsonsc@ahcdetroit.directbygreenway.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1689877649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 ANTHONY WAYNE DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023947",
            "telephone_number": "313-577-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 ANTHONY WAYNE DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023947",
            "telephone_number": "313-577-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON-SCIPIO",
        "first_name": "WANDA",
        "middle_name": "MAREA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704123322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "GIBSON-SCIPIO",
            "middle_name": "MAREA",
            "credential": "FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.