Blaine Gibby, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O-1940 Issued in ID

Practice address

730 N College Rd Ste a&B
Twin Falls, ID 83301-3416

Phone

(208) 814-8000

Fax

(208) 933-4919

NPI assigned

May 3, 2017

Last updated

May 1, 2024By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke's Jerome Hospital, Jerome, ID, CCN 131310

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment Care Compare group NPD
• Freeman Regional Health Services

  • Rural Health Clinic/Center
  • Marion, SD
  • NPI 1740570076
  Medicare reassignment NPD
• Freeman Regional Health Services

  • Clinic/Center
  • Freeman, SD
  • NPI 1508156290
  NPD
• Rural Medical Clinics

  • Clinic/Center
  • Freeman, SD
  • NPI 1851362354
  NPD
• St Luke's Magic Valley Regional Medical Center LTD

  dba St Lukes Retail Pharmacy Twin Falls

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)
• Center for Family Medicine

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1164493672
  NPD (past)
• Center for Family Medicine

  • Community Health Worker
  • Sioux Falls, SD
  • NPI 1235898073

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Luke's Magic Valley Regional Medical Center LTD

  dba St Luke's Jerome

  • Critical Access Hospital
  • Jerome, ID
  • NPI 1366874877
  Care Compare affiliation
• St. Luke's Magic Valley Regional Medical Center, LTD.

  dba St Lukes Magic Valley - Air Ambulance

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1013443555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N COLLEGE RD STE A&B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013416",
            "telephone_number": "208-814-8000",
            "fax_number": "208-933-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 S Walnut St",
            "address_purpose": "LOCATION",
            "city": "Freeman",
            "state": "SD",
            "postal_code": "570292033",
            "country_code": "US",
            "telephone_number": "605-925-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBY",
        "first_name": "BLAINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12127",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013443555",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffroi a. Golay, D.C., PLLC
• Laurie Hewitt Geren, LCPC
• Matthew D Geske, LCPC
• Julie J Gibbons, MS, CCC-SLP
• Matthew Michael Gibbs, DO
• John Patrick Gibney, M.D.
• Katelyn Marie Gilbert
• Stefanie Gilbert, MSW
• Amy Marie Gill, FNP-BC
• Cara Gill, M.S., CCC-SLP

• Family Medicine Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.