Individual provider Active NPI

Jonatha Gibaud, PH,D.

  • Clinical Psychologist
  • Nashville, TN
National Provider Identifier
1811053093
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P578 Issued in TN
Practice address
6726 Pennywell Dr
Nashville, TN 37205-3010
Phone
(615) 356-5696
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P578 TN Primary

Addresses

Primary practice location

6726 Pennywell Dr
Nashville, TN 37205-3010

Mailing address

6726 Pennywell Dr
Nashville, TN 37205-3010
Phone (615) 356-5696

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

LicenseStateTypeSpecialty
P578TNMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811053093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6726 PENNYWELL DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372053010",
            "telephone_number": "615-356-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6726 PENNYWELL DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372053010",
            "telephone_number": "615-356-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBAUD",
        "first_name": "JONATHA",
        "name_prefix": "Dr.",
        "credential": "PH,D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

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.

Verify at the official NPI Registry.