Individual provider Active NPI

Ashley Morgan Keating Gibbs, FNP-BC

  • Family Nurse Practitioner
  • Conway, SC
National Provider Identifier
1881958239
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18980 Issued in SC
Practice address
2367 B Cypress Circle
Conway, SC 29526-8921
Phone
(843) 349-1001
Fax
(843) 349-1008
NPI assigned
Jun 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18980 SC Primary

Addresses

Primary practice location

2367 B Cypress Circle
Conway, SC 29526-8921

Mailing address

300 Singleton Ridge Rd
Attn PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

4022 Postal Way Ste C
Myrtle Beach, SC 29579-3537
Phone (843) 903-4111

Other identifiers 1

IdentifierTypeStateIssuer
NP2943MedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013001413 SC Practitioner - Nurse Practitioner 3476702259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18980SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Conway Hospital, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Conway Hospital, Inc. Family Past Accepting new patients

Locations

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

2367B Cypress Cir
Conway, SC 29526
Phone (843) 349-1001

4022 Postal Way
Ste C
Myrtle Beach, SC 29579
Phone (843) 347-8037

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1341014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1881958239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 B CYPRESS CIRCLE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268921",
            "telephone_number": "843-349-1001",
            "fax_number": "843-349-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4022 Postal Way Ste C",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295793537",
            "country_code": "US",
            "telephone_number": "843-903-4111",
            "fax_number": "843-903-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "ASHLEY",
        "middle_name": "MORGAN KEATING",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-30",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2943",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.