NPIMap

Organization Active NPI

Gibson General Hospital, Inc

Doing business as Deaconess Gibson Gastro Gateway

  • Gastroenterology Physician
  • Newburgh, IN
National Provider Identifier
1093300188
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GIBSON GENERAL HOSPITAL, INC
Doing business as
Deaconess Gibson Gastro Gateway
Practice address
4219 Gateway Blvd
Newburgh, IN 47630-7925
Phone
(812) 842-2701
Fax
(812) 842-2717
NPI assigned
Mar 2, 2021
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Lois Morgan
Title
VP
Phone
(812) 385-9237

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

4219 Gateway Blvd
Newburgh, IN 47630-7925

Mailing address

PO Box 1197
Evansville, IN 47706-1197
Phone (812) 842-2701

Other names 1

  • Deaconess Gibson Gastro Gateway Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050131000887 IN Part B Supplier - Clinic/Group Practice 5991788069 Receives reassigned benefits from 39 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Princeton, IN; Newburgh, IN; Fort Branch, IN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gibson General Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1093300188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1197",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061197",
            "telephone_number": "812-842-2701",
            "fax_number": "812-842-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307925",
            "telephone_number": "812-842-2701",
            "fax_number": "812-842-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON GENERAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "812-385-9237"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess Gibson Gastro Gateway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.