Theresa R Gribbin, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102943 Issued in FL

Practice address

31581 US Highway 19 N
Palm Harbor, FL 34684-3724

Phone

(727) 772-0819

NPI assigned

Mar 28, 2006

Last updated

Jun 19, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Omni Pain Care, LLCGroup PAC ID 6406135839, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Omni Pain Care, LLC

  dba Omni Spine & Joint - Riverview

  • Interventional Pain Medicine Physician
  • Riverview, FL
  • NPI 1962955765
  Medicare reassignment Care Compare group NPD
• Florida Musculoskeletal Surgical Group LLC

  dba ORTHOCARE Florida

  • Orthopaedic Surgery Physician
  • St Petersburg, FL
  • NPI 1073850160
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1780645168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31581 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843724",
            "telephone_number": "727-772-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31581 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843724",
            "telephone_number": "727-772-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIBBIN",
        "first_name": "THERESA",
        "middle_name": "R",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Green, PT, DPT
• Lee Allen Greenberg, CPO/LPO
• Lisa Ellen Greenfield, LAT
• Gregory R. Filion DDS PA (Palm Lake Dental Group)
• Diana Beach Grello
• Randy W Griffin, DMD
• Jared Allan Grimes, NBC-HIS
• Maitlin Grimes, DPT
• Steven A Gross, MD
• Guardian Angel Caregiver

• Physician Assistant in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.