Organization Active NPI

Gibbs Natural Healing Centre, PC

  • Chiropractor
  • Beaverton, OR
National Provider Identifier
1780849653
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GIBBS NATURAL HEALING CENTRE, PC
Practice address
1975 NW 167TH PL Ste 100
Beaverton, OR 97006-4908
Phone
(503) 522-4148
Fax
(503) 738-9946
NPI assigned
Jul 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Authorized official

Name
Mary Ann Gibbs, D.C.
Title
Secretary
Phone
(503) 522-4148

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X

Addresses

Primary practice location

1975 NW 167TH PL Ste 100
Beaverton, OR 97006-4908

Mailing address

1975 NW 167TH PL Ste 100
Beaverton, OR 97006-4908
Phone (503) 522-4148

Other identifiers 1

IdentifierTypeStateIssuer
862925000OtherORREGENCE BLUE CROSS

Other names 1

  • Gibbs Natural Healing Centre Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140718000919 OR Part B Supplier - Clinic/Group Practice 6800012329 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seaside, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1780849653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "503-522-4148",
            "fax_number": "503-738-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 NW 167TH PL STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064908",
            "telephone_number": "503-522-4148",
            "fax_number": "503-738-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBBS NATURAL HEALING CENTRE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "503-522-4148",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS",
            "identifier": "862925000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibbs Natural Healing Centre",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.