DR. WILLIAM BRYAN GIBBONEY (NPI# 1225202864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225202864 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM BRYAN GIBBONEY |
| Credential | DNP, FNP-C, ACNP-BC |
| Practice Address |
1434 Central Ave E Wiggins MS 39577-9602 |
| Mailing Address |
6699 Old Fort Bayou Rd Ocean Springs MS 39564-7987 |
| Practice Telephone | 2284361191 |
| Mailing Telephone | 2288724349 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2019-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R861831 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R861831 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICARE PTAN | 512I500588 | 01 |
| MS | 01030384 | 05 |
| Street Address |
1434 CENTRAL AVE E |
| City | WIGGINS |
| State | MS |
| Zip Code | 39577-9602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386654309 | Stone County Hospital, Inc. | General Acute Care Hospital | 1434 Central Ave E, P O Drawer 97, Wiggins, MS 39577-9602 | 2006-08-09 |
| 1427687060 | Autrionne D Monroe | Speech-Language Pathologist | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2020-04-06 |
| 1134779200 | Memorial Hospital At Gulfport | Ambulance | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2019-09-19 |
| 1548817117 | Memorial Hospital At Gulfport | General Acute Care Hospital | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2019-08-19 |
| 1114481488 | Hannah Leigh Fore | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2019-01-30 |
| 1386125383 | Kendra Iesha Samuel | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2018-08-27 |
| 1891223186 | Christine L Ladner | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577 | 2017-05-31 |
| 1013452473 | Evelyn Perreault Rutledge | Social Worker | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2016-12-21 |
| 1225488281 | La'toria Evans | Physical Therapy Assistant | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2016-06-20 |
| 1437413770 | Joshua Carmi Alderman IIi | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2012-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1235468190 | Stone County School District | Local Education Agency (LEA) | 214 Critz Street, Wiggins, MS 39577 | 2009-12-23 |
| 1043452493 | Stone County Hospital, Inc | General Acute Care Hospital | 1434 E Central Ave., Wiggins, MS 39577 | 2009-04-01 |
| 1245274414 | James Walter Holmes | Family Medicine | 975 Hall Street, Wiggins, MS 39577 | 2006-06-16 |
| 1790962637 | The Vision Center Pa | Optometrist | 1113 Central Ave E, Wiggins, MS 39577 | 2008-01-23 |
| 1821009465 | County Discount Drugs, Inc. | Durable Medical Equipment & Medical Supplies | 820 Hall St, Wiggins, MS 39577-2100 | 2006-08-10 |
| 1154430940 | Batson Physical Therapy, Inc. | Clinic/Center | 711 Hall St, Wiggins, MS 39577-2105 | 2006-08-29 |
| 1033723937 | Katherine B Tyree | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2020-09-08 |
| 1114569340 | Johelen K Trisler | Physical Therapy Assistant | 711 Hall St, Wiggins, MS 39577-2105 | 2019-10-09 |
| 1720502586 | Sheila S Carney | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2017-08-02 |
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| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164086716 | Charles Ray Strange IIi | Nurse Practitioner | 1130 Frontage Dr W, Wiggins, MS 39577-8165 | 2019-04-30 |
| 1548774037 | Maranda L Husley | Nurse Practitioner | 87 Sellers St, Wiggins, MS 39577-8741 | 2017-11-20 |
| 1386125383 | Kendra Iesha Samuel | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577-9602 | 2018-08-27 |
| 1851816797 | Crystal Renee Stafford | Nurse Practitioner | 975 Hall St, Wiggins, MS 39577-2107 | 2017-08-12 |
| 1891223186 | Christine L Ladner | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577 | 2017-05-31 |
| 1922381466 | Michelle Mcqueen Johnson | Nurse Practitioner | 975 Hall St, Wiggins, MS 39577-2107 | 2011-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
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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.