Tara Traci Gibson, PT

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

PT38351 Issued in FL

Practice address

100 Waymont CT Ste 120
Lake Mary, FL 32746-3412

Phone

(502) 759-2444

NPI assigned

Dec 21, 2017

Sex

Female

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)

Enrolled

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1871009225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WAYMONT CT STE 120",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463412",
            "telephone_number": "502-759-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WAYMONT CT STE 120",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463412",
            "telephone_number": "502-759-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TARA",
        "middle_name": "TRACI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "FL",
            "license": "PT38351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treesa George
• Marissa Perri Geraghty, BCBA
• Sherry Labib Gergis, M.D.
• Linnea Gerness
• Meg Gibson
• Katie Giewont, BCBA
• Robert Adam Gilman, DACM, AP
• Elias M Gizaw, M.D.
• Jade Erin Gladsky
• Sasha Michelle Glasper, LMHC

• Neurology Physical Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Neurology Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.