Duane Phillip Gibson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10077T Issued in CA

Practice address

817 Court St
Suite 10
Jackson, CA 95642-2156

Phone

(209) 223-2020

Fax

(209) 223-2046

NPI assigned

Sep 14, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: duane.gibson@direct.revolutionehr.com

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1083609101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COURT ST",
            "address_2": "SUITE 10",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422156",
            "telephone_number": "209-223-2020",
            "fax_number": "209-223-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COURT ST",
            "address_2": "SUITE 10",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422156",
            "telephone_number": "209-223-2020",
            "fax_number": "209-223-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DUANE",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10077T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0100771",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Michelle Gardner
• Christina Monique Garvin, DPM
• Gary G Shi MD Inc (Northern California Cancer Specialists)
• Kathleen Gast, MFTI
• Robbi Geyser
• Harpreet K Gill, DDS
• Mark Godbout, RPH
• Gold Country Health Initiative, LLC
• Amanda Lee Gold, AMFT#143867
• Elizabeth Gomez

• Optometrist in Jackson, CA
• Providers in Jackson, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.