Individual provider Active NPI

Karl Wesley Gibson, RPH

  • Pharmacist
  • Gretna, LA
National Provider Identifier
1891963096
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13664 Issued in LA
Practice address
1581 Carol Sue Ave
Suite E
Gretna, LA 70056-5100
Phone
(504) 394-9037
NPI assigned
Feb 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13664 LA Primary

Addresses

Primary practice location

1581 Carol Sue Ave
Suite E
Gretna, LA 70056-5100

Mailing address

1581 Carol Sue Ave
Suite E
Gretna, LA 70056-5100
Phone (504) 394-9037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13664LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1891963096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 CAROL SUE AVE",
            "address_2": "SUITE E",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565100",
            "telephone_number": "504-394-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 CAROL SUE AVE",
            "address_2": "SUITE E",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565100",
            "telephone_number": "504-394-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KARL",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "13664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.