Susan Mae Gibbons, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60448842 Issued in WA

Practice address

501 SE 172ND Ave Ste 110
Vancouver, WA 98684

Phone

(360) 882-2778

Fax

(360) 604-1773

NPI assigned

Aug 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Susan Mae Chen Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Duke University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment Care Compare group NPD
• The Vancouver Clinic Inc PS

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Pharmacy

  • Pharmacist
  • Vancouver, WA
  • NPI 1336365857
  NPD (past)
• Stephen a Mitchell

  • Physical Therapist
  • Milwaukie, OR
  • NPI 1194058362
  NPD (past)

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1992998710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 SE 192nd Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986077415",
            "country_code": "US",
            "telephone_number": "360-210-5440",
            "fax_number": "360-210-7731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 SE 192nd Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986077415",
            "country_code": "US",
            "telephone_number": "360-210-5440",
            "fax_number": "360-210-7731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6542 SE Lake Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972222245",
            "country_code": "US",
            "telephone_number": "503-496-4550",
            "fax_number": "503-496-4551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "SUSAN",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60448842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2094452",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "CHEN",
            "middle_name": "MAE",
            "prefix": "MRS.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Douglass Gibb, MD
• Cynthia Lyn Gibbons
• Erin P Gibbons, M.D.
• Julia Marie Gibbons, ARNP
• Lisa Michelle Gibbons, DO
• Karen Lynn Gibbs, LICSW
• Debra Jean Gibeson
• Zeweditu T Gibrehiwot
• Ollie Gibson-Lavell, LICSW
• Brettyn Carole Gibson

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.