KALLIE RAE GIBSON (PT) – Physical Therapist, NPI 1104451764

Physical Therapist

KALLIE RAE GIBSON (PT) is a healthcare provider. based in Fleming island, Florida. specializing in Physical Therapist. They hold the professional credentials PT. They hold a License No. PT34368 (FL). The NPI Number for KALLIE RAE GIBSON (PT) is 1104451764

Main info

Female

8 Years Of Experience

Accepts Medicare Assignment

Name

KALLIE RAE GIBSON (PT)

NPI

1104451764

Phone

Not provided

Address

PO BOX 8847

Enumeration Date

4 March 2020

Last Update Date

4 March 2020

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9042591649

Graduation Year

2018 (8 years ago)

PAC ID

6406285493

Group Practice PAC ID

8123005147

Professional Enrollment ID

I20200326000159

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience36

Completeness75

Years active:6State licenses:1Digital endpointsOther names

Provider Addresses for KALLIE RAE GIBSON (PT)

PO BOX 8847
FLEMING ISLAND, FL 320060019
Phone:
Type: Mailing
534 S 5TH ST
MACCLENNY, FL 320632602
Phone: (904) 259-1649
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32006)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 8123005147View full group profile

Name	Specialty	State
YOUNGCHAN LEE	Physical Therapist In Private Practice	CA
MR. AARON P SR. ROBLES (MPT, CFMT)	Physical Therapist In Private Practice	FL
ZACHARY ENGEL (DPT)	Physical Therapist In Private Practice	FL
NOAH KREITZ (PT)	Physical Therapist In Private Practice	FL
JOHN J GOETZE (MSPT)	Physical Therapist In Private Practice	FL
THOMAS SIMPSON	Physical Therapist In Private Practice	IL
DAWN SPARKMAN (PT)	Physical Therapist In Private Practice	FL
KATHRYN MARIE WOOD (PT, DPT)	-	FL
JOHN C FIEGE (PT)	-	FL

Reviews

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Frequently asked questions

Can I use this page to confirm KALLIE RAE GIBSON (PT)'s NPI?

Yes. KALLIE RAE GIBSON (PT) is listed with NPI 1104451764 in the public NPI dataset.

Is KALLIE RAE GIBSON (PT) listed as active for patients and plans?

The listing shows KALLIE RAE GIBSON (PT) as active in the NPI system.

What taxonomy line describes KALLIE RAE GIBSON (PT)?

For research purposes, treat KALLIE RAE GIBSON (PT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.

What address line appears for KALLIE RAE GIBSON (PT)?

KALLIE RAE GIBSON (PT)'s geographic hint is Fleming Island, Florida in our summary view.

Is the information about KALLIE RAE GIBSON (PT) up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."