Pamela Gibson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-139230 Issued in AL

Practice address

52 S Valley Ave Ste B
Collinsville, AL 35961-3263

Phone

(256) 524-3090

Fax

(256) 524-2885

NPI assigned

Jul 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13303/brand/1/csg/1/fhir/r4

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Florence, AL
  • NPI 1639679962
  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  Family Medicine

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Wills Valley Family Medicine LLC

  • Family Medicine Physician
  • Collinsville, AL
  • NPI 1316103237
  NPD (past)

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1902450281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 S VALLEY AVE STE B",
            "city": "COLLINSVILLE",
            "state": "AL",
            "postal_code": "359613263",
            "telephone_number": "256-524-3090",
            "fax_number": "256-524-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 S VALLEY AVE STE B",
            "city": "COLLINSVILLE",
            "state": "AL",
            "postal_code": "359613263",
            "telephone_number": "256-524-3090",
            "fax_number": "256-524-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PAMELA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-139230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collinsville Express Drugs LLC
• Collinsville Nursing Home, Inc
• Dekalb Baptist Medical Center Home Health
• Fort Payne Clinic Corp
• Fort Payne RHC Corp
• Misty Sharp Ingram, CRNP
• Sunil K Jaiswal, MD
• Judith Womack Jones, ARNP
• Kilgore Express Pharmcy Inc
• Frances H. Koe, MD

• Family Nurse Practitioner in Collinsville, AL
• Providers in Collinsville, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.