Active NPI
Kim A Gibson, CPHT
- Other Technician
- Richardson, TX
National Provider Identifier
1770601569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 1601-0161-7665-478
- Practice address
- 57 Arapaho Village Ctr
Richardson, TX 75080-5001 - Phone
- (972) 235-7133
- Fax
- (972) 235-6968
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 1601-0161-7665-478 | TX | Primary |
Addresses
Primary practice location
57 Arapaho Village Ctr
Richardson, TX 75080-5001
Mailing address
57 Arapaho Village Ctr
Richardson, TX 75080-5001
Phone (972) 235-7133
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 |
|---|---|---|---|
| 1601-0161-7665-478 | TX | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770601569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 ARAPAHO VILLAGE CTR",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750805001",
"telephone_number": "972-235-7133",
"fax_number": "972-235-6968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 ARAPAHO VILLAGE CTR",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750805001",
"telephone_number": "972-235-7133",
"fax_number": "972-235-6968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "KIM",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "CPHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "TX",
"license": "1601-0161-7665-478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.