Jill D Gibson, M.D.

Key facts

NPI

1033348487

Entity type

Individual (NPI type 1)

Primary specialty

Gynecology Physician 207VG0400X

License

47651 (AZ)

Practice address

1313 E Osborn Rd Ste 250
Phoenix, AZ 85014-5699

Phone

(602) 265-9161

Fax

(602) 265-1823

NPI assigned

Jul 7, 2009

Sex

Female

Sole proprietor

Yes

Organizations & group practices 6

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.

• District Medical Group, Inc Anatomic Pathology & Clinical Pathology Physician · Phoenix, AZ · NPI 1336472448
  Medicare reassignment NPD AZ
• Maricopa County Special Health Care District General Acute Care Hospital · Phoenix, AZ · NPI 1073576740
  Medicare reassignment NPD AZ
• District Medical Group, Inc Emergency Medicine Physician · Phoenix, AZ · NPI 1144624339
  NPD
• District Medical Group, Inc Internal Medicine Physician · Phoenix, AZ · NPI 1295968162
  NPD FAMILY MEDICINE
• Maricopa County Special Health Care District Federally Qualified Health Center (FQHC) · Mesa, AZ · NPI 1306265145
  NPD
• Maricopa County Special Health Care District Federally Qualified Health Center (FQHC) · Phoenix, AZ · NPI 1295154045
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgibson262692@direct.valleywisehealth.org

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 18, 2015.

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1033348487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E OSBORN RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145699",
            "telephone_number": "602-265-9161",
            "fax_number": "602-265-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E OSBORN RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145699",
            "telephone_number": "602-265-9161",
            "fax_number": "602-265-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JILL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "NOT YET ISSUED",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "47651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "809194",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

• Amanda Gibson, CRNA
• Amy Gibson, ATC LAT
• Andrew Gibson, DPT
• Colleen M Gibson, RDH
• Dorley Tarnue Gibson
• Kristina Yvonne Gibson, PA
• Matthew A Gibson, CRNFA
• Michael Gibson, LPC
• Morgan Marie Gibson
• Renee Gibson, LCSW

All providers in Phoenix, AZ · Gynecology Physician in Arizona