Olivia Ruth Gibson, RN/APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN113495 Issued in GA

Practice address

515 Riverside Dr
Waycross, GA 31501-5316

Phone

(912) 283-5729

Fax

(912) 490-5774

NPI assigned

Jul 7, 2006

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Olivia Ruth Hayes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Brunswick, GA
  • NPI 1346423191
  NPD
• Bacon County Board of Health

  • Public Health or Welfare Agency
  • Alma, GA
  • NPI 1063457398
  NPD (past)
• Brantley County Board of Health

  • Public Health or Welfare Agency
  • Nahunta, GA
  • NPI 1730116120
  NPD (past)
• Charlton County Board of Health

  • Public Health or Welfare Agency
  • Folkston, GA
  • NPI 1508894171
  NPD (past)
• Pierce County Board of Health

  • Public Health or Welfare Agency
  • Blackshear, GA
  • NPI 1689603979
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1942233762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 RIVERSIDE DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015316",
            "telephone_number": "912-283-5729",
            "fax_number": "912-490-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 RIVERSIDE DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015316",
            "telephone_number": "912-283-5729",
            "fax_number": "912-490-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "OLIVIA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "RN/APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN113495",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN113495",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000759536I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "HAYES",
            "middle_name": "RUTH",
            "credential": "RN/APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Georgia Anesthesia Medical Group, LLC
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• Georgia Em-I Medical Services, PC
• Georgia Infectious Disease Consultants
• Georgia Spine & Pain Centers
• Kelly Matthew Gilbert, D.C.
• Robert Allen Giles Jr., MD
• David Robert Gill, MSHS, PA
• Roger Robert Gillis, LPC
• Angela Michelle Given, PHARM.D., R.PH

• Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.