ERNEST LEONARD GIBSON – Psychiatric/Mental Health Nurse Practitioner, NPI 1023766862

ERNEST LEONARD GIBSON is a healthcare provider. based in Decatur, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN207432 (GA). The NPI Number for ERNEST LEONARD GIBSON is 1023766862

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
ERNEST LEONARD GIBSON
NPI
1023766862
Phone
(404) 839-2886
Address
2561 CAPTAINS ROW
Enumeration Date
11 March 2022
Last Update Date
11 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7709916044
Graduation Year
2021 (5 years ago)
PAC ID
5294188546
Group Practice PAC ID
4486684784
Professional Enrollment ID
I20240202000531
Address ID
GA303495317CO5454XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for ERNEST LEONARD GIBSON

  • 2561 CAPTAINS ROW

    DECATUR, GA 300353062

    Phone: (404) 839-2886

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $168.

Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.

Last reported payment date: 2024-02-29 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($66).

Total Amount

$168

General + Research + Ownership

Payments

5

Total payment records

General Amount

$168

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-29

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240202000531INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 30035)

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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: 4486684784View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA

Reviews

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Frequently asked questions

What is the standard ID for ERNEST LEONARD GIBSON in the U.S.?
In the U.S., ERNEST LEONARD GIBSON is identified by NPI 1023766862.
Should I treat ERNEST LEONARD GIBSON as an active provider?
Patients and plans typically see ERNEST LEONARD GIBSON as active in the national extract.
What services align with ERNEST LEONARD GIBSON's listing?
ERNEST LEONARD GIBSON's public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ERNEST LEONARD GIBSON?
ERNEST LEONARD GIBSON is associated with Decatur, Georgia in the same public data insurers reference.
Who maintains ERNEST LEONARD GIBSON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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