KAREN GIBBS
NPI 1215550116
Nurse Practitioner in Williston, VT
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Secondary Locations
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 7
- Nurse Practitioner
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KAREN GIBBS
This page provides the complete NPI Profile along with additional information for Karen Gibbs, a provider established in Williston, Vermont with a medical specialization in Nurse Practitioner and more than 7 years of experience. She graduated from University Of Vermont College Of Medicine in 2020. The healthcare provider is registered in the NPI registry with number 1215550116 assigned on May 2020. The practitioner's primary taxonomy code is 363L00000X with license number 101-0134577 (VT). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1215550116
- Provider Name
- KAREN GIBBS
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 353 BLAIR PARK RD WILLISTON, VT 05495
- Location Phone
- (802) 847-1470
- Mailing Address
- 104 IROQUOIS AVE ESSEX JUNCTION, VT 05452
- Mailing Phone
- (802) 324-4273
- Medical School Name
- UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
- Graduation Year
- 2020
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-26-2020
- Last Update Date
- 03-27-2025
- Code Navigator
A nurse practitioner (NP) like Karen Gibbs is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Secondary Locations
- 142 Woodridge Rd
Berlin, VT 05602
(802) 371-4700
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 101-0134577
- License State
- VT
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 101.0134545-EMGY (VT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Karen Gibbs is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Karen Gibbs is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1153731377
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20201029000865
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Unknown
Treatment-Treatment - Miscellaneous (RX029N)
Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)
1 DME suppliers used 14 Medicare Claims 844 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Nursing facility discharge management, more than 30 minutes
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
This service was performed 18 times for 18 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 30 times for 17 patientsFollow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 31 times for 11 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 26 times for 26 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 58 times for 43 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 28 times for 26 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.47 for a new patient copayment and $24.6 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 05495 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.8
- Maximum New Patient Price $168.48
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.95
- Maximum New Patient Copayment $42.12
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98.4
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.84
- Average Established Patient Copayment $24.6
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.46
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Karen Gibbs is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE | 111 COLCHESTER AVE BURLINGTON, VT 05401 | (802) 847-0000 | Acute Care Hospitals |
Reviews for KAREN GIBBS
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215550116, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 44. The final step is to find the difference between that total and the next multiple of ten (50 - 44 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 44 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WILLISTON, VT 05495
WILLISTON, VT 05495
WILLISTON, VT 05495
WILLISTON, VT 05495
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215550116, enumerated as an "individual" on May 26, 2020.
The provider is located at 353 BLAIR PARK RD WILLISTON, VT 05495 and the phone number is (802) 847-1470.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
Karen Gibbs is affiliated with: UNIV. OF VERMONT - FLETCHER ALLEN HEALTH CARE.
