Matthew Mackinnon Gibbs
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · St Simons Is, GA
NPI 1982186342 · NPPES record last updated Sep 2, 2018
Key facts
- NPI
- 1982186342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 211 Village Dr
St Simons Is, GA 31522 - Phone
- (912) 580-9811
- NPI assigned
- Sep 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
211 Village Dr
St Simons Is, GA 31522
Mailing address
211 Village Dr
St Simons Is, GA 31522
Phone (912) 580-9811
Other providers in St Simons Is, GA
- Julia Anne Casey
- Raleeta Dianne Davis
- Dental Center of St Simons
- Hunter Farthing
- Ronald Tracy Gerken
- Gail Katherine Godwin
- Karen Heller Griffith
- Stephanie Griggs
- Mary Janus
- Kari E. Kizzire
All providers in St Simons Is, GA · Student in an Organized Health Care Education/Training Program in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.