William G Gibson IV, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10136 Issued in MN

Practice address

460 S Eliot Ave
Rush City, MN 55069-6505

Phone

(320) 358-0987

Fax

(320) 358-3422

NPI assigned

Sep 23, 2014

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• All About Caring Home Care LLC

  • In Home Supportive Care Agency
  • Rush City, MN
  • NPI 1134307119
  NPD
• All About Caring Home Care. Inc

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Rush City, MN
  • NPI 1528313079
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1003218876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "RUSH CITY",
            "state": "MN",
            "postal_code": "550690370",
            "telephone_number": "320-358-0987",
            "fax_number": "320-358-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 S ELIOT AVE",
            "city": "RUSH CITY",
            "state": "MN",
            "postal_code": "550696505",
            "telephone_number": "320-358-0987",
            "fax_number": "320-358-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "name_suffix": "IV",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2512775",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17029-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Cowan, M.S.
• Dragonfly Children's Respite Home Inc.
• Gretchen Ann Erickson, REGISTERED NURSE
• Estates at Rush City LLC
• Fairview Clinics (Fairview Clinics-Rush City)
• Kaitlyn Marie Grell I, LPTA
• Diane Rose Hardee, R.N.
• Delores M Kaiserlik, RN
• William H E Kieper, DDS
• April Marie Klar, LPN

• Family Nurse Practitioner in Rush City, MN
• Providers in Rush City, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.