Hollis Gibson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1404 Shenandoah Dr
Watkinsville, GA 30677-8373

Phone

(770) 380-8404

NPI assigned

Feb 24, 2025

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1841096385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 SHENANDOAH DR",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306778373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 SHENANDOAH DR",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306778373",
            "telephone_number": "770-380-8404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 Shenandoah Dr",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306778373",
            "country_code": "US",
            "telephone_number": "770-380-8404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "HOLLIS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Skin Cancer & Aestheitic Dermatology, LLC
• Georgia Skin Cancer Surgery Center, LLC
• Georgia TRD Clinic, LLC
• Georgia Women's Care, PC
• Marguertie Kathleen Gibbs, LCSW
• Raymond L Gilbert Jr., M.D.
• Tuwanna Gilham, RBT
• Michael Jack Ginter, BSW
• John Bruce Glenn
• Ashlyn Baxley Gober, OTR/L

• Physician Assistant in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.