Individual provider Active NPI

William Bays Gibson, DPT

  • Physical Therapist
  • Salem, VA
National Provider Identifier
1043350291
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305203663 Issued in VA
Practice address
2119 Apperson Dr
Salem, VA 24153-7235
Phone
(540) 772-8022
Fax
(540) 527-0055
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305203663 VA Primary

Addresses

Primary practice location

2119 Apperson Dr
Salem, VA 24153-7235

Mailing address

2119 Apperson Dr
Salem, VA 24153-7235
Phone (540) 772-8022

Other identifiers 5

IdentifierTypeStateIssuer
193442OtherVAANTHEM PT LOC 5
193431OtherVAANTHEM PT LOC 1
249624OtherVAANTHEM PT LOC 6
193434OtherVAANTHEM PT LOC 2
193437OtherVAANTHEM PT LOC 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000096 VA Practitioner - Physical Therapist in Private Practice 4981612934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lucas Physical Therapy IncGroup PAC ID 8123087970, 13 clinicians

Practice addresses (Care Compare)

512 McDowell Ave NE
Suite a
Roanoke, VA 24016-1532
Phone (540) 772-8022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lucas Physical Therapy Inc Physical Therapist CurrentSince Feb 19, 2005 Accepting new patients

Locations

3960 Valley Gateway Blvd
Ste A3
Roanoke, VA 24012

4325 Brambleton Ave
Ste A
Roanoke, VA 24018

512 McDowell Ave NE
Ste A
Roanoke, VA 24016

4533 Brambleton Ave
Roanoke, VA 24018
Phone (540) 989-1246

2119 Apperson Dr
Salem, VA 24153
Phone (540) 685-0168

109 Knotbreak Rd
Salem, VA 24153

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043350291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 APPERSON DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537235",
            "telephone_number": "540-772-8022",
            "fax_number": "540-527-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 APPERSON DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537235",
            "telephone_number": "540-772-8022",
            "fax_number": "540-527-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WILLIAM",
        "middle_name": "BAYS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305203663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT LOC 5",
            "identifier": "193442",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT LOC 1",
            "identifier": "193431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT LOC 6",
            "identifier": "249624",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT LOC 2",
            "identifier": "193434",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PT LOC 3",
            "identifier": "193437",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • 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.
  • 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.