Melissa Gibson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146016541 Issued in IL

Practice address

106 E 7TH St
Gridley, IL 61744-9241

Phone

(309) 220-8030

NPI assigned

Aug 18, 2021

Sex

Female

Sole proprietor

Yes

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.

• Gibson Pediatric Speech Services

  • Speech-Language Pathologist
  • Gridley, IL
  • NPI 1306530845
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2023.

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1851067979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E 7TH ST",
            "city": "GRIDLEY",
            "state": "IL",
            "postal_code": "617449241",
            "telephone_number": "309-220-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 7TH ST",
            "city": "GRIDLEY",
            "state": "IL",
            "postal_code": "617449241",
            "telephone_number": "309-220-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146016541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen T. Blue, D.D.S.
• Jeanie Christine Bree
• Gibson Pediatric Speech Services
• Gridley Fire Protection District
• Caleb Joseph Kaupp, EMT
• Charles L. Proesel Jr., D.D.S.
• Ansley Ridgeway
• Sarah Jane Ruff, P.T.

• All providers in Gridley, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.