DEBOORAH A GIBSON (NPI# 1780844613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780844613 |
| Entity Type | Individual |
| Full Name | DEBOORAH A GIBSON |
| Practice Address |
28131 Newberry Trail Lindstrom MN 55045 |
| Practice Telephone | 6516573684 |
| Mailing Telephone | 6516573684 |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
1020292-1-AFC | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 49-80610 | 01 |
| MN | UCARE | 161648 | 01 |
| Street Address |
28131 NEWBERRY TRAIL |
| City | LINDSTROM |
| State | MN |
| Zip Code | 55045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043818354 | Eddiction Medicine Pllc | Clinic/Center | 12018 285th Street, Lindstrom, MN 55045 | 2020-10-09 |
| 1831356773 | Lake Optometric Vision Pa | Optometrist | 12700 Lake Blvd, Lindstrom, MN 55045 | 2008-05-19 |
| 1861534315 | Vernon Bruce Lovdokken | Optometrist | 12700 Lake Boulevard, Lindstrom, MN 55045 | 2007-02-13 |
| 1922167329 | Robert Donald Waddell Jr. | Chiropractor | 12099 Lake Blvd, Lindstrom, MN 55045 | 2006-12-08 |
| 1366516767 | Kimberley M Johnson Dc | Chiropractor | 12814 Lake Boulevard, Lindstrom, MN 55045 | 2006-11-17 |
| 1225112022 | Lindstrom Family Dentistry LLC | Dentist | 30554 Park Street North, Lindstrom, MN 55045 | 2006-10-25 |
| 1508959164 | Joseph Virga | Chiropractor | 12670 Lake Blvd, Lindstrom, MN 55045 | 2006-10-02 |
| 1609975713 | Four Winds Center for Wellness Inc | Social Worker | 28141 Lakelawn Drive, Lindstrom, MN 55045 | 2006-09-22 |
| 1629079983 | Michael A Hursh | Dentist | 30554 Park St, Lindstrom, MN 55045 | 2005-08-09 |
| 1083615405 | Matthew Struve | Dentist | 30554 Park Street, Lindstrom, MN 55045 | 2005-08-09 |
| Find all providers in zip 55045 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844384 | First Mercy Homes LLC | Custodial Care Facility | 15723 Fair Hill Way, Apple Valley, MN 55124-5256 | 2020-02-25 |
| 1386275980 | Krista Maylene Tupker | Custodial Care Facility | 14490 Lynx Rd, Milaca, MN 56353-3019 | 2020-02-01 |
| 1437700499 | Amanda Sue Moen | Custodial Care Facility | 700 105th St Nw, Rice, MN 56367-8656 | 2019-09-21 |
| 1467006601 | Michelle M Green | Custodial Care Facility | 13709 Apollo Way, Rosemount, MN 55068-2171 | 2019-07-25 |
| 1750947743 | Victor G. Makori | Custodial Care Facility | 17017 Georgetown Way, Rosemount, MN 55068-5159 | 2019-05-15 |
| 1134698814 | Sharry Mae Stensrud | Custodial Care Facility | 25 E Broadway, Plainview, MN 55964-1531 | 2018-11-25 |
| 1770080442 | Christophe Benzi | Custodial Care Facility | 1403 Nicole Ct, Fergus Falls, MN 56537-3326 | 2018-04-10 |
| 1225542608 | All Hopes Incorporated | Custodial Care Facility | 9937 Linnet St Nw, Coon Rapids, MN 55433-4721 | 2017-11-21 |
| 1003368309 | Amazing Love Elderly Care Center LLC | Custodial Care Facility | 7807 Emerald Rd, Randall, MN 56475-2428 | 2016-11-03 |
| 1902268857 | Gaudencio Fuentes Celeste | Custodial Care Facility | 8674 134th St W, Apple Valley, MN 55124-7234 | 2016-03-21 |
| Find all providers with the same taxonomy | ||||
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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.