Jacob Christopher Gibney, LAT, ATC, CEAS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

092420 Issued in IA

Practice address

450 Laurel St
Des Moines, IA 50314-3045

Phone

(515) 323-6485

NPI assigned

Feb 24, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1790484129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 HILLSIDE DR",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503272337",
            "telephone_number": "563-468-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143045",
            "telephone_number": "515-323-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBNEY",
        "first_name": "JACOB",
        "middle_name": "CHRISTOPHER",
        "credential": "LAT, ATC, CEAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "092420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Gianaras, PHARMD
• Rebecca Ann Gibbon, MD
• Mackenzie Erin Gibbons
• Racheal Gibbons
• Melisa Sue Gibbs
• Holly Gibson, CRNA
• Laura Elizabeth Gibson, CRC, T-LMCH
• Seth William Gibson, D.O.
• Deborah Maria Giddings, PA-C
• Jeanne Giddings, DO

• Athletic Trainer in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.