MARK GIBSON (NPI# 1619391802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619391802 |
| Entity Type | Individual |
| Full Name | MARK GIBSON |
| Credential | CPO |
| Practice Address |
3334 Capital Medical Blvd #400 Tallahassee FL 32308-4470 |
| Practice Telephone | 8508778174 |
| Practice Fax Number | 8508775636 |
| Mailing Telephone | 8508778174 |
| Mailing Fax Number | 8508775636 |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | POR276 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 224P00000X | Prosthetist | POR276 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 951939400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434380 | Mark S. Gibson | Specialist/Technologist, Other | 2104 Blind Pond Ave, Lutz, FL 33549-5580 | 2013-09-17 |
| 1215211008 | Mark J. Gibson | Social Worker | 3610 American River Dr Ste 140, Sacramento, CA 95864-5919 | 2011-09-28 |
| 1922324276 | Mark Duane Gibson | Military Health Care Provider | Uss Louisville, Fpo, AP 96671-2404 | 2010-04-12 |
| 1225115561 | Mark Tanner Gibson | Psychologist | 175 River View Dr, Green River, WY 82935-4811 | 2006-11-01 |
| 1437133444 | Mark C Gibson | Optometrist | 16306 E Lake Shore Dr, Austin, TX 78734-1132 | 2005-12-02 |
| 1720083439 | Mark William Gibson | Chiropractor | 7a Reich Street, Marsing, ID 83639-0252 | 2005-06-17 |
| 1417231465 | Mark W Gibson | Pharmacist | 1982 Eight Mile Rd, Cincinnati, OH 45255-2609 | 2011-10-07 |
| 1174845259 | Mark Anthony Gibson II | Physical Therapist | 1028 E Main St, Morehead, KY 40351-1328 | 2010-02-17 |
| 1710122106 | Mark Alan Gibson | Radiology | 545 Ne 47th Ave Ste 215, Portland, OR 97213-2237 | 2008-12-13 |
| 1780737437 | Mark S Gibson | Emergency Medicine | 3200 E Racine St, Janesville, WI 53546-2343 | 2007-01-18 |
| Street Address |
3334 CAPITAL MEDICAL BLVD #400 |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518934694 | Hank Lawrence Hutchinson | Orthopaedic Surgery | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2006-03-07 |
| 1710129408 | Edward Robert Jackson II | Orthopaedic Surgery | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2009-03-27 |
| 1528145356 | Kimberly R Hagen | Nurse Practitioner | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063740066 | Mitchell W Bowman | Prosthetist | 3334 Capital Medical Blvd, Suite 400, Tallahassee, FL 32308-8405 | 2009-12-02 |
| 1558453118 | Christopher J Wells | Prosthetist | 3334 Capital Medical Blvd, Ste. 100, Tallahassee, FL 32308-8405 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796275 | Mireille Alexis | Prosthetist | 4376 Fl-7, Coral Springs, FL 33073 | 2020-10-08 |
| 1588279434 | Kourtney James | Prosthetist | 715 Lori Dr Apt 304, Palm Springs, FL 33461-7104 | 2020-09-08 |
| 1750910790 | Gabriela Jamur | Prosthetist | 11308 Bonita Beach Rd Se Ste 105-a, Bonita Springs, FL 34135-5912 | 2020-04-02 |
| 1013543701 | Kateau Cerisme | Prosthetist | 320 N Magnolia Ave, Orlando, FL 32801-1624 | 2020-03-13 |
| 1780217174 | Amber Baker | Prosthetist | 1340 Naples Cir Apt 309, Rockledge, FL 32955-2577 | 2020-02-13 |
| 1992336192 | Antakeisha Lavonte Hepburn | Prosthetist | 2326 Nw 51st St, Miami, FL 33142-3677 | 2020-01-28 |
| 1164067211 | Rayna K Bradley | Prosthetist | 148 Lake Ave, Maitland, FL 32751-6424 | 2019-11-13 |
| 1376001982 | Kerryann Williams | Prosthetist | 6515 Nw 1st St, Margate, FL 33063-5101 | 2019-03-04 |
| 1528526126 | Latoya Patrick | Prosthetist | 11361 Sheffield Rd, Spring Hill, FL 34608-2260 | 2019-03-04 |
| 1275091878 | Debbie Denizard | Prosthetist | 9560 Lem Turner Rd, Jacksonville, FL 32208-7501 | 2019-03-04 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.