Active NPI
Timothy Gibbs
- Neurology Physician
- Columbia, SC
National Provider Identifier
1881399210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- LL89913
- Practice address
- 1 Richland Medical Park Dr
Columbia, SC 29203-6834 - Phone
- (803) 434-1895
- NPI assigned
- Apr 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | LL89913 | SC | Primary |
Addresses
Primary practice location
1 Richland Medical Park Dr
Columbia, SC 29203-6834
Mailing address
1 Richland Medical Park Dr
Columbia, SC 29203-6834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230905000972 | SC | Order and Referring Only - Neurology | 4284097551 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL89913 | SC | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1881399210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 RICHLAND MEDICAL PARK DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 RICHLAND MEDICAL PARK DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036834",
"telephone_number": "803-434-1895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-04",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "SC",
"license": "LL89913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.