Susanna A Gibson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020268 Issued in CA

Practice address

3225 Timber Fall CT Ste B
Eureka, CA 95503-4892

Phone

(707) 442-5700

NPI assigned

Feb 22, 2022

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Planned Parenthood: Shasta-Diablo, Inc.

  dba Planned Parenthood Northern California

  • Non-Surgical Family Planning Clinic/Center
  • Eureka, CA
  • NPI 1609286418
  NPD (past)

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1952057655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 PACHECO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202309",
            "telephone_number": "925-676-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 TIMBER FALL CT STE B",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034892",
            "telephone_number": "707-442-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SUSANNA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "798142",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravenna Giannotta
• Gregory N Gibb, MD
• Michelle Gibbons
• Solomon Gibeau
• Michael A Gibson II
• Tyler Gibson, RN
• Elijah John Gikas
• Isabelle Gilbert
• Mariane Gilbert, FNP
• Rebecca Corinne Gilbride, RN

• Family Nurse Practitioner in Eureka, CA
• Providers in Eureka, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; 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.