Active NPI
Shannon Nicole Gibson, P.A.-C
- Physician Assistant
- Katy, TX
National Provider Identifier
1730562190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 588159
- Practice address
- 21770 Kingsland Blvd
Katy, TX 77450-2513 - Phone
- (281) 646-0740
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 588159 | TX | Primary |
Addresses
Primary practice location
21770 Kingsland Blvd
Katy, TX 77450-2513
Mailing address
21770 Kingsland Blvd
Katy, TX 77450-2513
Phone (281) 646-0740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 588159 | TX | MD | Physician Assistant |
Interoperability endpoints
- shannon.gibson@almouiemd.directbygreenway.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1730562190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21770 KINGSLAND BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774502513",
"telephone_number": "281-646-0740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21770 KINGSLAND BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774502513",
"telephone_number": "281-646-0740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "SHANNON",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-02",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "588159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.