Individual provider Active NPI

James E Gibbs, MD

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1083717565
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME108274 Issued in FL
Practice address
2450 Mason Ave
Daytona Beach, FL 32114-5110
Phone
(386) 676-7100
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014-02167 NC
Family Medicine Physician 207Q00000X 24750 WV
Family Medicine Physician 207Q00000X 35.043934 OH
Family Medicine Physician 207Q00000X 37406 SC
Family Medicine Physician 207Q00000X 0101256861 VA
Family Medicine Physician 207Q00000X 072607 GA
Family Medicine Physician 207Q00000X 51945 TN
Family Medicine Physician 207Q00000X 16754 NH
Family Medicine Physician 207Q00000X 47505 KY
Family Medicine Physician 207Q00000X MD042677 DC
Family Medicine Physician 207Q00000X E-10326 AR
Family Medicine Physician 207Q00000X ME108274 FL Primary

Addresses

Primary practice location

2450 Mason Ave
Daytona Beach, FL 32114-5110

Mailing address

2801 S Ridgewood Ave Unit 408
South Daytona, FL 32119-3505
Phone (216) 538-4729

Other practice location 1

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (415) 504-3838 ext. 9238

Other identifiers 6

IdentifierTypeStateIssuer
1083717565OtherFLVHN
14S8ZOtherFLBCBS
1083717565OtherFLMULTIPLAN
009602100MedicaidFL
1083717565OtherFLTRICARE
P01574249OtherFLRAILROAD

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20131018000095 FL Practitioner - Family Practice 7719957596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Johns Hopkins University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

740 Dunlawton Ave
Suite 200
Port Orange, FL 32127-4240
Phone (386) 763-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37406SCMDPharmacist
E-10326ARMDFamily Medicine Physician
MD042677DCMDFamily Medicine Physician
ME108274FLMDFamily Medicine Physician
072607GAMDFamily Medicine Physician
47505KYMDFamily Medicine Physician
2014-02167NCMDFamily Medicine Physician
16754NHMDFamily Medicine Physician
35.043934OHMDFamily Medicine Physician
51945TNMDFamily Medicine Physician
0101256861VAMDFamily Medicine Physician
24750WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Oct 1, 2013 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Oct 1, 2013 Accepting new patients
New Family Physicians Associates Inc Family Medicine Past Accepting new patients
Erie Banks Emergency Physicians LLC Past Accepting new patients

Locations

2450 Mason Ave
Daytona Beach, FL 32114
Phone (386) 676-7100

309 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 445-7073

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

740 Dunlawton Ave
Port Orange, FL 32127
Phone (386) 763-1000

Organizations & group practices 4

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1083717565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S RIDGEWOOD AVE UNIT 408",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193505",
            "telephone_number": "216-538-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145110",
            "telephone_number": "386-676-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 California St Ste 2300",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941115424",
            "country_code": "US",
            "telephone_number": "415-504-3838 x9238",
            "fax_number": "415-504-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2014-02167",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "24750",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.043934",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37406",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101256861",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "072607",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "51945",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "16754",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "47505",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD042677",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-10326",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME108274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VHN",
            "identifier": "1083717565",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14S8Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "1083717565",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009602100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1083717565",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01574249",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.