MEDICARE: SARAH CHRISTINE GIBBLE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	003578	OH
2	363A00000X	Physician Assistant	50.003578RX	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H150080	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821342320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH CHRISTINE GIBBLE PA

Provider Business Mailing Address
First Line	:	10506A MONTGOMERY RD STE 301
Second Line	:
City	:	MONTGOMERY
State	:	OH
Zip	:	45242-4402
Country	:	US
Telephone Number	:	513-246-2400
Fax Number	:	513-985-2905

Provider Business Practice Location Address
First Line	:	10506 MONTGOMERY RD STE 301A
Second Line	:
City	:	MONTGOMERY
State	:	OH
Zip	:	45242-4400
Country	:	US
Telephone Number	:	513-246-2400
Fax Number	:	513-985-2905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	06/09/2026

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Directions to “ SARAH CHRISTINE GIBBLE PA” Practice Location

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