Active NPI
Miral K Gibson, NP-C
- Family Nurse Practitioner
- Weston, WV
National Provider Identifier
1902054695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 34016
- Practice address
- 402 Medical Park Dr
Weston, WV 26452-1678 - Phone
- (304) 269-3929
- Fax
- (304) 269-3911
- NPI assigned
- Sep 5, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 34016 | WV | Primary |
Addresses
Primary practice location
402 Medical Park Dr
Weston, WV 26452-1678
Mailing address
132 Cinema Cir
Buckhannon, WV 26201-0000
Phone (304) 470-0670
Other practice location 1
132 Cinema Cir
Buckhannon, WV 26201
Phone (304) 473-0670
Other practice location 2
251 W 2nd St Ste 1
Weston, WV 26452-1602
Phone (304) 269-6620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810013138 | Medicaid | WV |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1902054695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 CINEMA CIR",
"city": "BUCKHANNON",
"state": "WV",
"postal_code": "262010000",
"telephone_number": "304-470-0670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 MEDICAL PARK DR",
"city": "WESTON",
"state": "WV",
"postal_code": "264521678",
"telephone_number": "304-269-3929",
"fax_number": "304-269-3911"
}
],
"practiceLocations": [
{
"address_1": "132 Cinema Cir",
"address_purpose": "LOCATION",
"city": "Buckhannon",
"state": "WV",
"postal_code": "26201",
"country_code": "US",
"telephone_number": "304-473-0670",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "251 W 2nd St Ste 1",
"address_purpose": "LOCATION",
"city": "Weston",
"state": "WV",
"postal_code": "264521602",
"country_code": "US",
"telephone_number": "304-269-6620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "MIRAL",
"middle_name": "K",
"credential": "NP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WV",
"license": "34016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810013138",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.