Individual provider Active NPI

Donald P Gibson, PHARMACIST

  • Pharmacist
  • Duluth, MN
National Provider Identifier
1023033297
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
110078-9 Issued in MN
Practice address
1502 London Road
Suite 101
Duluth, MN 55812-2915
Phone
(218) 733-1110
Fax
(218) 733-1112
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 110078-9 MN Primary

Addresses

Primary practice location

1502 London Road
Suite 101
Duluth, MN 55812-2915

Mailing address

1502 London Road
Suite 101
Duluth, MN 55812-2915
Phone (218) 733-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110078-9MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1023033297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 LONDON ROAD",
            "address_2": "SUITE 101",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122915",
            "telephone_number": "218-733-1110",
            "fax_number": "218-733-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LONDON ROAD",
            "address_2": "SUITE 101",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122915",
            "telephone_number": "218-733-1110",
            "fax_number": "218-733-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DONALD",
        "middle_name": "P",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "110078-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.