Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellie Jo Gibbens, PA-C

Individual provider Medical Physician Assistant · NPI 1902580426

Ellie Jo Gibbens, PA-C is a Physician Assistant in Greenville, South Carolina. Qualified in 2023, 3 years ago. Practices with Prisma Health Urgent Care of South Carolina PC, a 156-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and South Carolina.

Years since qualifying
3
Licensed in
CA, SC
In the registry since
2023
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

975 W Faris Rd
Greenville, SC 29605-4241
Phone: (864) 729-8330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11402 Anderson Rd, Greenville, SC 29611-7557 — (864) 631-2799

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5461 (SC)
Medical Physician Assistant Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X · Licence 63071 (CA)

Record details

NPI number1902580426
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 14, 2023
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Prisma Health Urgent Care Of South Carolina Pc — 156 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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