Gregory a Gibson M D P a

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

ME0060293 Issued in FL

Legal business name

GREGORY A GIBSON M D P A

Practice address

301 Health Park Blvd Ste 322
Saint Augustine, FL 32086-5771

Phone

(904) 824-3777

Fax

(904) 824-6050

NPI assigned

Jan 10, 2008

Last updated

Jan 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cindy Gibson

Title

Office Manager

Phone

(904) 824-3777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1801072756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD STE 322",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-824-3777",
            "fax_number": "904-824-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD STE 322",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865771",
            "telephone_number": "904-824-3777",
            "fax_number": "904-824-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY A GIBSON M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-824-3777"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME0060293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "12553",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J Greenblatt, MD
• Richard Alan Greene, O.D.
• David Lance Greenwald, M.D.
• Jessica Greer, LMT
• Greg Wolf (Greg)
• Alysa M Gregory, LCSW
• Suzanne Gregory
• Erin Elizabeth Walsh Gregos
• Nicole Lynn Gress, CNM
• Amanda Kay Griener, MPT

• Geriatric Medicine (Internal Medicine) Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.