Individual provider Active NPI

Kristen Elizabeth Gibb

  • Registered Nurse
  • East Wareham, MA
National Provider Identifier
1760658249
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
279951 Issued in MA
Practice address
504 Gatehouse Dr
East Wareham, MA 02538-1374
Phone
(339) 235-9492
NPI assigned
May 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 279951 MA Primary

Addresses

Primary practice location

504 Gatehouse Dr
East Wareham, MA 02538-1374

Mailing address

504 Gatehouse Dr
East Wareham, MA 02538-1374
Phone (339) 235-9492

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

LicenseStateTypeSpecialty
279951MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1760658249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 GATEHOUSE DR",
            "city": "EAST WAREHAM",
            "state": "MA",
            "postal_code": "025381374",
            "telephone_number": "339-235-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 GATEHOUSE DR",
            "city": "EAST WAREHAM",
            "state": "MA",
            "postal_code": "025381374",
            "telephone_number": "339-235-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBB",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "279951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.