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Deactivated NPI 1013971605 Deactivated / Inactive NPI Female Practitioner

Dr. Jacquelyn H Gibbons , MD

Pediatrics • Media, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jacquelyn Gibbons has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 12, 2006
NPI Deactivation Date December 11, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Jacquelyn Gibbons, MD was a registered Pediatrics practicing in Media, PA. Throughout an active medical career spanning 19 years, Dr. Gibbons provided care at the practice location at 100 GRANITE DR until profile deactivation on 2025-12-11.

Practice Location & Contact Primary Location

Practice Address

100 Granite Dr
Suite 200

Media, PA 190635134

Telephone 6105651945
Fax 6108927848
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Media, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
15 Specialists

Practicing in Media, PA (3505 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License PA MD006608E

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1215998380

Doctor of Medicine (M.D.)

NPI 1316908031

Doctor of Medicine (M.D.)

NPI 1346401155

Doctor of Medicine (M.D.)

NPI 1710948401

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 11, 2025

Record deactivated on December 11, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 100 GRANITE DR, SUITE 200, MEDIA, PA 190635134 (Tel: 6105651945)

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Updated Business Mailing Address July 08, 2007

Registered at 100 GRANITE DR, SUITE 200, MEDIA, PA 190635134 (Tel: 6105651945)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JACQUELYN GIBBONS, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #MD006608E in PA)

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Initial NPI Registration & Enumeration April 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013971605
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 12, 2006
Last Update: July 08, 2007
Deactivation Date: December 11, 2025

Mailing Address

100 Granite Dr, Suite 200

Media, PA 190635134

Phone: 6105651945

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.