Carol Lacy Gibson, FNP is a medicare enrolled "Nurse Practitioner - Family" in Mclean, Virginia. She graduated from nursing school in 2000 and has 25 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Minuteclinic Diagnostic Of Virginia Llc and her current practice location is
1452 Chain Bridge Rd, Mclean, Virginia. You can reach out to her office (for appointments etc.) via phone at
(571) 239-2765.
Carol Lacy Gibson is licensed to practice in Virginia (license number 0024164967) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1477833648.
Provider's Profile
| Full Name | Carol Lacy Gibson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 25 Years |
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| Location | 1452 Chain Bridge Rd, Mclean, Virginia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Carol Lacy Gibson graduated from nursing school in 2000
NPI Data:
- NPI Number: 1477833648
- Provider Enumeration Date: 08/19/2011
- Last Update Date: 09/09/2016
Medicare PECOS Information:
- PECOS PAC ID: 8729259502
- Enrollment ID: I20111107000509
Medical Identifiers
Medical identifiers for Carol Lacy Gibson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477833648 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 0024164967 (Virginia) | Primary |
| 363LF0000X | Nurse Practitioner - Family | RN62762 (District Of Columbia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R154036 (Maryland) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Minuteclinic Diagnostic Of Virginia Llc | 6709960891 | 150 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carol Lacy Gibson allows following entities to bill medicare on her behalf.
| Entity Name | Minuteclinic Diagnostic Of Virginia Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417076829
PECOS PAC ID: 6709960891
Enrollment ID: O20090123000189 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carol Lacy Gibson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Carol Lacy Gibson, FNP
1452 Chain Bridge Rd,
Mc Lean, VA 22101-3706
Ph: (571) 239-2765 | Carol Lacy Gibson, FNP
1452 Chain Bridge Rd,
Mclean, VA 22101
Ph: (571) 239-2765 |
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