Cristie Elvin Gibson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103062 Issued in NC

Practice address

1730 Kernersville Medical Pkwy Ste 104
Kernersville, NC 27284

Phone

(336) 765-5470

Fax

(336) 499-5428

NPI assigned

Jun 1, 2011

Last updated

Aug 3, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgibson427787@direct.novanthealth.org

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

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Deep River OBGYN

  • Obstetrics & Gynecology Physician
  • Kernersville, NC
  • NPI 1427928902
  NPD
• Novant Medical Group, Inc.

  dba Novant Health Maternal-Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Matthews, NC
  • NPI 1033566526
  NPD
• Novant Health Medical Group LLC

  dba Novant Health WomanCare

  • Obstetrics & Gynecology Physician
  • Kernersville, NC
  • NPI 1194113662
  NPD (past)
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1871887471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 104",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-765-5470",
            "fax_number": "336-499-5428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Charlois Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031522",
            "country_code": "US",
            "telephone_number": "336-765-5470",
            "fax_number": "336-499-5428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CRISTIE",
        "middle_name": "ELVIN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgibson427787@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1730 Kernersville Medical Pkwy Ste 104",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeevan Gautam, MD
• Subarna Gautam, M.D.
• Eric Gavour, MD
• Generations Family Practice, PA (Kernersville Primary Care)
• Tyana Geronimo
• Zyaire J Gill
• Meredith Glass
• Carentxa Iryva Goede
• Katherine Goings, PA-C
• Rosy Gonzalez Avila

• Physician Assistant in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.