Gibson of Jax, Inc.

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Legal business name

GIBSON OF JAX, INC.

Practice address

3775 Cricket Cove Rd E
Jacksonville, FL 32224-8401

Phone

(904) 254-0337

Fax

(904) 223-4368

NPI assigned

Sep 17, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Katherine Woody Gibson, MA, CCC-SLPNPI 1356441828

Title

President

Phone

(904) 254-0337

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Katherine W. Gibson, MA, CCC-SLP Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Woody Gibson, MA,CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
  • NPI 1356441828
  NPD (past) Authorized official

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1831422112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 CRICKET COVE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248401",
            "telephone_number": "904-254-0337",
            "fax_number": "904-223-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 CRICKET COVE RD E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248401",
            "telephone_number": "904-254-0337",
            "fax_number": "904-223-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON OF JAX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "WOODY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-254-0337",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 5525",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1356441828",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885295200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katherine W. Gibson, MA, CCC-SLP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sophie Gibbons
• Amanda Gibbs, PHARMD
• Austin Gibbs, DNP CRNA
• Evan Mackenzie Gibbs, MD
• Gibson Chiropractic Office, PA
• Neshe Michelle Gibson Rivera, BT
• Sara Gibson-Rivera
• Ashley Gibson
• Ashton Gibson, LPC
• Brittany Aneice Gibson, APRN, FNP-BC

• Developmental Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.