| Gibbs Comprehensive Care, Llc | |
|
1054 Highway 19 S Meridian MS 39301-8205 | |
| (601) 531-3200 | |
| (601) 531-3107 |
| Full Name | Gibbs Comprehensive Care, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1054 Highway 19 S, Meridian, Mississippi |
| Authorized Official Name and Position | Traci Lynn Gibbs (OWNER) |
| Authorized Official Contact | 6016928997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gibbs Comprehensive Care, Llc 1054 Highway 19 S Meridian MS 39301-8205 Ph: (601) 561-3200 | Gibbs Comprehensive Care, Llc 1054 Highway 19 S Meridian MS 39301-8205 Ph: (601) 531-3200 |
| NPI Number | 1538528294 |
|---|---|
| Provider Enumeration Date | 02/23/2016 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 3476850694 |
|---|---|
| Medicare Enrollment ID | O20160401000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538528294 | NPI | - | NPPES |
| 02408898 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stephen Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548277700 PECOS PAC ID: 2961407242 Enrollment ID: I20060919000568 |
| Provider Name | Traci Gibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104074210 PECOS PAC ID: 3577692227 Enrollment ID: I20100519000110 |
| Provider Name | Mary Larkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013056555 PECOS PAC ID: 9436348984 Enrollment ID: I20110113001025 |
| Provider Name | Katrina M Landrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962280263 PECOS PAC ID: 2668820051 Enrollment ID: I20231124000280 |
| Provider Name | Courtney M Hollie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912537317 PECOS PAC ID: 8820432719 Enrollment ID: I20240219003598 |
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