Leticia M Gibbs, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-100307 Issued in AL

Practice address

2900 Spring Hill Ave
Mobile, AL 36607-1822

Phone

(251) 287-8420

Fax

(251) 287-8477

NPI assigned

Apr 11, 2013

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

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL, MS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leticia.gibbs.1@30520.direct.athenahealth.com

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Florence, AL
  • NPI 1639679962
  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Mercy Life of Alabama

  • PACE Provider Organization
  • Mobile, AL
  • NPI 1952609059
  NPD (past)

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1871936641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366071822",
            "telephone_number": "251-284-8420",
            "fax_number": "251-284-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366071822",
            "telephone_number": "251-287-8420",
            "fax_number": "251-287-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "LETICIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-100307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI SITE GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PAYEE NUMBER",
            "identifier": "011846",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leticia.gibbs@mercylifeal.com",
            "affiliation": "N",
            "endpointDescription": "mercy.life.of.alabama@trinityhealthga.medicity.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd",
            "address_1": "2900 Spring Hill Ave",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366071822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Joy Giambrone, CRNP
• John Vincent Gianini, D.C.
• Kevin Giattina, DO
• Angela Brittani Gibbons, PHARMD
• Emily Gibbs, AUD
• Paula Gibson
• Shawana Kacher Gibson
• Tracy Gibson, LPC
• Tyson Jay Gibson, PA-C
• Kimberly Dawn Giddens, CRNP

• Family Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.