Shane M. Giblin, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT6171 Issued in CA

Practice address

7485 Mission Valley Rd
Suite 104 a
San Diego, CA 92108-4422

Phone

(619) 291-8930

Fax

(619) 398-4989

NPI assigned

Jan 9, 2008

Sex

Male

Sole proprietor

No

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1700061678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7485 MISSION VALLEY RD",
            "address_2": "SUITE 104 A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084422",
            "telephone_number": "619-291-8930",
            "fax_number": "619-398-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7485 MISSION VALLEY RD",
            "address_2": "SUITE 104 A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084422",
            "telephone_number": "619-291-8930",
            "fax_number": "619-398-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBLIN",
        "first_name": "SHANE",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT6171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Gibbs, RBT
• Michael Warren Gibbs, MD
• Neil Frank Gibbs, M.D.
• Nicholas Gibbs
• Travis Gibbs
• Joshua Mark Gibney, M.D.
• Courtney Jean Giboi, PSY.D.
• Jennifer Christine Giboney, M.D.
• Aaron Gibson
• Alexandra Gibson, PT, DPT

• Physical Therapy Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.