Individual provider Active NPI

Alexandria Gibby, APRN-CNP

  • Family Nurse Practitioner
  • Tishomingo, OK
National Provider Identifier
1962392100
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
203717 Issued in OK
Practice address
610 E 24TH St
Tishomingo, OK 73460-3245
Phone
(580) 387-0509
Fax
(580) 218-8963
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 203717 OK Primary

Addresses

Primary practice location

610 E 24TH St
Tishomingo, OK 73460-3245

Mailing address

610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 387-0509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20251011000513 OK Practitioner - Nurse Practitioner 9133616436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center of Southern Oklahoma IncGroup PAC ID 4284537457, 34 clinicians

Practice addresses (Care Compare)

610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 387-0509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Southern Oklahoma Inc CurrentSince Sep 29, 2025 Accepting new patients
Family Health Center of Southern Oklahoma Inc CurrentSince Sep 29, 2025 Accepting new patients
Family Health Center of Southern Oklahoma Inc Current Accepting new patients

Locations

457 S Mississippi Ave
Atoka, OK 74525
Phone (580) 207-3800

107 E Post Ave
Coalgate, OK 74538
Phone (580) 927-2828

610 E 24th St
Tishomingo, OK 73460
Phone (580) 371-2343

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1962392100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-387-0509",
            "fax_number": "580-218-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-387-0509",
            "fax_number": "580-218-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBY",
        "first_name": "ALEXANDRIA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "203717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, OK

Sources for this page

Verify at the official NPI Registry.