Active NPI
Ebony Lache Gibson
- Health Educator
- Upper Marlboro, MD
National Provider Identifier
1972309904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 10530 Campus Way S Ste 1223
Upper Marlboro, MD 20774-1309 - Phone
- (888) 912-5922
- NPI assigned
- Feb 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary | ||
| Community Health Worker | 172V00000X |
Addresses
Primary practice location
10530 Campus Way S Ste 1223
Upper Marlboro, MD 20774-1309
Mailing address
10530 Campus Way S Ste 1223
Upper Marlboro, MD 20774-1309
Phone (888) 912-5922
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": "1740009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1972309904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10530 CAMPUS WAY S STE 1223",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207741309",
"telephone_number": "888-912-5922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10530 CAMPUS WAY S STE 1223",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207741309",
"telephone_number": "888-912-5922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "EBONY",
"middle_name": "LACHE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-20",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.