Jeff Gibbons, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1623 Issued in ID

Practice address

2311 Park Ave Ste 2
Burley, ID 83318-2170

Phone

(208) 677-2489

Fax

(208) 677-4023

NPI assigned

Dec 1, 2006

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

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Proactive Physical Therapy PC

  • Physical Therapist
  • Burley, ID
  • NPI 1609093434
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821166281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 PARK AVE STE 2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182170",
            "telephone_number": "208-677-2489",
            "fax_number": "208-677-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 PARK AVE STE 2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182170",
            "telephone_number": "208-677-2489",
            "fax_number": "208-677-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JEFF",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Garey, MSCCC-SLP
• Steve Paul Garn, D.D.S.
• Val Garn, D.D.S.
• Generations Together LLC
• Cinneamon Lee Geppelt, CNM, WHNP
• Gilbert K Crane MD
• Shiloh Gilbert, M.D.
• Andrea Gochnour
• Alexa Sanaa Gonzales, COTA
• Veronica Marie Gonzalez, MS

• Physical Therapist in Burley, ID
• Providers in Burley, ID by specialty
• Physical Therapist in Idaho

• 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.