Shawna Marie Gibbs, LPN ADON

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043104570 Issued in IL

Practice address

3354 Jerome LN
Cahokia Heights, IL 62206-2604

Phone

(618) 337-9400

Fax

(618) 337-9394

NPI assigned

Nov 23, 2021

Last updated

Jan 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1700543857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 JEROME LN",
            "city": "CAHOKIA HEIGHTS",
            "state": "IL",
            "postal_code": "622062604",
            "telephone_number": "618-337-9400",
            "fax_number": "618-337-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 JEROME LN",
            "city": "CAHOKIA HEIGHTS",
            "state": "IL",
            "postal_code": "622062604",
            "telephone_number": "618-337-9400",
            "fax_number": "618-337-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "credential": "LPN ADON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043104570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgibbs@briahs.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work secure email",
            "address_1": "3354 Jerome Ln",
            "city": "Cahokia Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622062604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Licensed Practical Nurse in Cahokia Heights, IL
• Providers in Cahokia Heights, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.