Taylor A Gibson, APRN
Individual provider Active NPI Family Nurse Practitioner · Jamestown, KY
NPI 1760169130 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1760169130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4010096 (KY)
- Practice address
- 1417 N Main Street
Jamestown, KY 42629-0966 - Phone
- (270) 343-2597
- Fax
- (270) 343-2598
- NPI assigned
- Jun 28, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cumberland Family Medical Center Inc
PT Pros, Inc
Practice addresses (Care Compare)
102 Rhodes St
Gamaliel, KY 42140-8942
Phone (270) 457-3000
360 Keen St
Burkesville, KY 42717-7915
Phone (270) 864-2889
404 Steve Dr
Russell Springs, KY 42642-4622
Phone (270) 866-3161
792 Campbellsville Rd
Greensburg, KY 42743-1460
Phone (270) 973-5400
Hospital & facility affiliations
- Russell County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231103002797 | KY | Practitioner - Nurse Practitioner | 8426405093 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4010096 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Family Medical Center Inc | Current | Accepting new patients | |
| Cumberland Family Medical Center Inc | Current |
Accepting new patients | |
| Cumberland Family Medical Center Inc | Current |
Accepting new patients | |
| Cumberland Family Medical Center Inc | Past |
Accepting new patients |
Locations
360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472
478 Whirlaway Dr
#200
Danville, KY 40422
Phone (859) 236-3208
333 S 3rd St
Ste A
Danville, KY 40422
Phone (859) 236-7712
1417 N Main St
Jamestown, KY 42629
Phone (270) 343-2597
1025 S Main St
Monticello, KY 42633
Phone (606) 340-8870
341 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 676-8186
1900 N Highway 27
Whitley City, KY 42653
Phone (606) 376-5391
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4010096 | KY | Yes |
Addresses
Primary practice location
1417 N Main Street
Jamestown, KY 42629-0966
Mailing address
PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 868-6655
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15937325 | Other | CAQH |
Other providers in Jamestown, KY
- Fair Oaks Health and Rehabilitation LLC
- Fair Oaks Health Systems, LLC
- Andrea Farlee
- Jamie Ford
- Maretta Garner
- Teresa Gleason
- Skyler Gosser
- Melanie Grant
- Amy Grider
- Angela Hamilton
All providers in Jamestown, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.