Tara Lynn Gibson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME119861 Issued in FL

Practice address

12901 Bruce B Downs Blvd # 41
Tampa, FL 33612-4742

Phone

(813) 844-7412

Fax

(813) 844-7995

NPI assigned

Mar 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tara Lynn Amato Other name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1912296120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10751 GLEN ELLEN DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336245060",
            "telephone_number": "813-451-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-844-7412",
            "fax_number": "813-844-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME119861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "AMATO",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kirby Gibson
• Lacie Gibson
• Natalie Gibson
• Rachel Moore Gibson, MS, RD, LDN
• Samantha Josephine Gibson, MD
• Warren Carrico Gibson, MS CCC SLP
• Maria Giddarie, FNP-BC
• Michelle Giddens
• Joann M Gierbolini, M.D.
• Maria Gieron-Korthals, MD

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.