Jacqueline S Gibson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25302 Issued in KY

Practice address

740 S Limestone
Lexington, KY 40536-0001

Phone

(859) 323-5661

NPI assigned

Aug 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgibson57896@ukhcdirect.org

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

• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448
  Medicare reassignment NPD

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033128871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083215",
            "telephone_number": "859-257-7910",
            "fax_number": "859-257-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "25302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64253024",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corinne Elizabeth Gibson, MD
• Elijah Gibson, PHARMD
• Erica Gibson, RRT
• Ethan Dwane Gibson, PHARMD
• Halie Christian Gibson
• Jonah Matthew Gibson
• Jordan Lane Gibson, RN
• Michaela Gibson
• Millie Lou Gibson
• Stephanie L Gibson, LCSW

• Internal Medicine Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.