Individual provider Active NPI

Brooke Gibson

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1770117889
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11010698 Issued in FL
Practice address
1 Tampa General Cir FL 33606
Tampa, FL 33606-3571
Phone
(813) 844-7000
NPI assigned
Feb 27, 2020
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11010698 FL Primary
Registered Nurse 163W00000X 9486144 FL

Addresses

Primary practice location

1 Tampa General Cir FL 33606
Tampa, FL 33606-3571

Mailing address

3211 Tour Trce
Land O Lakes, FL 34638-4432
Phone (727) 439-2577

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brookeliston@usf.edu Direct University of South Florida

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203000047 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911311980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9486144FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 1, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2020 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Interoperability endpoints

  • Direct secure messaging: bliston158756@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1770117889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 TOUR TRCE",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384432",
            "telephone_number": "727-439-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR FL 33606",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11010698",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9486144",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brookeliston@usf.edu",
            "affiliation": "Y",
            "endpointDescription": "USF Email",
            "affiliationName": "University of South Florida",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "13101 Bruce B Downs Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336123803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.