Douglas Aaron Gibson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.132225-M-IV Issued in OH

Practice address

59247 Armstrong Centerville Rd
Jacobsburg, OH 43933-9797

Phone

(740) 213-5299

NPI assigned

Dec 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1992009369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59247 ARMSTRONG CENTERVILLE RD",
            "city": "JACOBSBURG",
            "state": "OH",
            "postal_code": "439339797",
            "telephone_number": "740-213-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59247 ARMSTRONG CENTERVILLE RD",
            "city": "JACOBSBURG",
            "state": "OH",
            "postal_code": "439339797",
            "telephone_number": "740-213-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DOUGLAS",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.132225-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Amos
• Gwendolyn Ann Baker, L.P.N.
• Karen Elizabeth Day
• Jennifer Louise Hezoucky, MT-BC
• Danielle Rose Hoover
• Justin A Hoover
• Kevin Duane Moore
• Susan Renee Reitter

• All providers in Jacobsburg, OH
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.