Bethany T Gibson, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036115524 Issued in IL

Practice address

101 W McKinley Ave
Enta Allergy, Head & Neck Institute
Decatur, IL 62526

Phone

(217) 876-3682

Fax

(217) 876-3345

NPI assigned

May 1, 2006

Last updated

Sep 4, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1043278013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-3345",
            "fax_number": "217-876-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MCKINLEY AVE",
            "address_2": "ENTA ALLERGY, HEAD & NECK INSTITUTE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-876-3682",
            "fax_number": "217-876-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BETHANY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036115524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Marie Gee, CRNA MSN
• Dalton Geisler
• Genoa Healthcare LLC
• Shelby Geralds
• Krista Gerhardt
• Daena Gibson
• Gifted Hands of Care
• Amy A Gillen
• William Garver Gillen, PHD LCPC
• Clifton Gillispie

• Allergy & Immunology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.