JACK GIBBONS
NPI 1487456307
Student in an Organized Health Care Education/Training Program in Grand Forks, ND

Q: What is Jack Gibbons's NPI number?

The NPI number for Jack Gibbons is 1487456307. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Q: What is Jack Gibbons's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Gibbons was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 24, 2025PECOS Enrolled

1301 N COLUMBIA RD, GRAND FORKS, ND 58202(701) 777-2514 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jack Gibbons NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK GIBBONS (NPI 1487456307) is an individual student in an organized health care education/training program in Grand Forks, North Dakota and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487456307

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK GIBBONS

Location Address1301 N COLUMBIA RDGrand Forks, ND 58202-6098

Mailing Address1301 N Columbia RdGrand Forks, ND 58202-6098 · (701) 777-2514

Phone(701) 777-2514

Sole ProprietorNo

Enumeration DateMarch 24, 2025

NPPES CertifiedMarch 24, 2025

✔ NPI 1487456307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1301 N COLUMBIA RD, Grand Forks, ND 58202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Gibbons is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY ANN SENS MD

Pathology (Anatomic Pathology)