Individual ProviderBrad GibsonSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address5606 S 147th St, Omaha, NE 68137-2648(402) 715-8200PECOS EnrollmentBased on the most recent information from CMS, provider Brad Gibson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 7:33 AM.Profile DetailsProvider ID1518330265Provider TypeIndividualFull NameGibson, BradTitleMr.GenderMaleSole ProprietorNoEnumeration Date11/3/2015Last Updated11/3/2015Contact InformationPractice LocationPractice Address5606 S 147th St, Omaha, NE 68137-2648Phone(402) 715-8200FaxUnlisted FaxMailing LocationMailing Address5606 S 147th St, Omaha, NE 68137-2648Phone(402) 715-8200FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID8699807512DescriptionOtherIssuerNDE STAFF IDNebraska