Active NPI
Angel Gibson
- Speech-Language Pathologist
- Byram, MS
National Provider Identifier
1972147361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 170 Blackmon Rd
Byram, MS 39272-6039 - Phone
- (601) 978-0230
- NPI assigned
- Oct 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
170 Blackmon Rd
Byram, MS 39272-6039
Mailing address
170 Blackmon Rd
Byram, MS 39272-6039
Phone (601) 978-0230
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": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1972147361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 BLACKMON RD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392726039",
"telephone_number": "601-978-0230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 BLACKMON RD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392726039",
"telephone_number": "601-978-0230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "ANGEL",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-29",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Byram, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.