Douglas T Gibbens MD LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MA06225500 Issued in NJ

Legal business name

DOUGLAS T GIBBENS MD LLC

Practice address

766 Shrewsbury Ave
Suite 207
Tinton Falls, NJ 07724-3001

Phone

(732) 530-8989

Fax

(732) 530-6365

NPI assigned

Mar 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Douglas T Gibbens, M.D.

Title

President

Phone

(732) 530-8989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1104097682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 SHREWSBURY AVE",
            "address_2": "SUITE 207",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243001",
            "telephone_number": "732-530-8989",
            "fax_number": "732-530-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 SHREWSBURY AVE",
            "address_2": "SUITE 207",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077243001",
            "telephone_number": "732-530-8989",
            "fax_number": "732-530-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS T GIBBENS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "GIBBENS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-530-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "MA06225500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.