Individual provider Active NPI

Carol Marie Gibson, NONE

  • Religious Nonmedical Nursing Personnel
  • Chubbuck, ID
National Provider Identifier
1942150164
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical Nursing PersonnelTaxonomy code 374T00000X
Practice address
4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone
(208) 252-5621
Fax
(208) 252-5621
NPI assigned
Jan 28, 2026
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Nursing Personnel 374T00000X NU Primary

Addresses

Primary practice location

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Mailing address

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone (208) 252-5621

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

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1942150164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-252-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CAROL",
        "middle_name": "MARIE",
        "credential": "NONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.