Simon Jack Gibson, DNP, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

GAA-CRNA000891 Issued in GA

Practice address

8915 Potomac Dr
Chattanooga, TN 37421-2008

Phone

(601) 826-9031

NPI assigned

Jan 16, 2017

Sex

Male

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 TN, GA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified 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 and National Provider Directory roles.

• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• North Georgia Anesthesia Services PC

  • Anesthesiology Physician
  • Dalton, GA
  • NPI 1114545431
  Medicare reassignment NPD

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

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1982140844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N CEDAR BLUFF RD",
            "address_2": "STE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379233632",
            "telephone_number": "865-342-8900",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 POTOMAC DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212008",
            "telephone_number": "601-826-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SIMON",
        "middle_name": "JACK",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "GAA-CRNA000891",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "877434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Gibbs, D.D.S.
• Katherine Gibson, MA, LPC-MHSP
• Lindsey Gibson, RN
• Lynn M Gibson, CRNA
• Sarah Katherine Gibson, DPT
• Teri Taylor Gibson, CRNA
• Travis James Gibson
• Lauren Gielas
• Anita Katherine Gienapp, BEHAVIOR TECHNICIAN
• Cheryl Giest, O.T.D., OTR/L

• Certified Registered Nurse Anesthetist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.