Gibbs Wound Care LLC

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

0236239 Issued in MO

Legal business name

GIBBS WOUND CARE LLC

Practice address

2210 Barron Rd
Room 205
Poplar Bluff, MO 63901-1908

Phone

(573) 686-4133

Fax

(573) 778-1099

NPI assigned

Nov 10, 2015

Organization subpart

No

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

Authorized official

Name

Devona D Gibbs, FNP

Title

Nurse Practitioner

Phone

(573) 686-4133

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Damon Davis, AHCNS

  • Adult Health Clinical Nurse Specialist
  • Poplar Bluff, MO
  • NPI 1699003210
  Medicare reassignment NPD
• Laurie J. De Luca, MD

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Tampa, FL
  • NPI 1740235738
  NPD (past)

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1902279110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "ROOM 205",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-778-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD",
            "address_2": "ROOM 205",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4133",
            "fax_number": "573-778-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBBS WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "DEVONA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "573-686-4133",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MO",
            "license": "0236239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF NURSING",
            "identifier": "064033",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Avery Gentry
• George F. Blaich, DMD & Associates, PC
• Cliff George
• Alexandros Georgolios, MD
• Matthew Douglas Geyer, PSY.D.
• Devona J Gibbs, FNP
• James William Gieselmann, MD
• Gilbert D. Smith, M.D., LLC
• Gilbert D. Smith, MD, LLC
• Anderson Mark Gilberto, DDS

• Critical Care Medicine Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Critical Care Medicine Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.