HALEY NICOLE GIBSON (PT,DPT) – Physical Therapist, NPI 1073464996

HALEY NICOLE GIBSON (PT,DPT) is a healthcare provider. based in Macon, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT,DPT. They hold a License No. PT018186 (GA). The NPI Number for HALEY NICOLE GIBSON (PT,DPT) is 1073464996

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
HALEY NICOLE GIBSON (PT,DPT)
NPI
1073464996
Phone
(478) 745-4206
Address
3708 NORTHSIDE DR
Enumeration Date
6 February 2026
Last Update Date
17 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4787454206
Graduation Year
2025 (1 year ago)
PAC ID
6901388347
Group Practice PAC ID
7911994835
Professional Enrollment ID
I20260304003141
Address ID
GA312102404MA3708XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for HALEY NICOLE GIBSON (PT,DPT)

  • 3708 NORTHSIDE DR

    MACON, GA 312102404

    Phone: (478) 745-4206

    Fax: (478) 832-6506

    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)

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-04

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
I20260304003141IPhysical Therapist In Private PracticeGATBD

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 31210)

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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: 7911994835View full group profile
NameSpecialtyState
Hand Surgery, Orthopedic SurgeryGA
Orthopedic SurgeryGA
-GA
Nurse PractitionerGA
Physical Therapist In Private PracticeTX
-GA
Orthopedic SurgeryGA
Occupational Therapist In Private PracticeGA
Nurse PractitionerGA
Orthopedic Surgery, Sports MedicineGA

Reviews

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Frequently asked questions

What federal number belongs to HALEY NICOLE GIBSON (PT,DPT)?
The federal identifier for HALEY NICOLE GIBSON (PT,DPT) is NPI 1073464996.
Is HALEY NICOLE GIBSON (PT,DPT) active in the national directory?
HALEY NICOLE GIBSON (PT,DPT)'s public NPI profile is in an active state.
What kind of provider is HALEY NICOLE GIBSON (PT,DPT)?
The page reflects Physical Therapist for HALEY NICOLE GIBSON (PT,DPT). Clinical services aligned with this taxonomy classification.
Where is HALEY NICOLE GIBSON (PT,DPT)'s primary listing?
We display Macon, Georgia because that is what the record indicates for HALEY NICOLE GIBSON (PT,DPT).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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