Kerri Lyn Gibson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036177585 Issued in IL

Practice address

1701 E College Ave
Bloomington, IL 61704-2101

Phone

(309) 664-3000

Fax

(309) 664-3026

NPI assigned

Mar 14, 2011

Sex

Female

Sole proprietor

No

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  IL

  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572

  Family Medicine, OH

  Medicare reassignment NPD
• Alliance Physicians, Inc.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Beavercreek, OH
  • NPI 1306235114
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806

  Hospital

  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

University of Toledo College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Merit-based Incentive Payment System (MIPS)

Final score

84.8 of 100Reported as group

Quality

73.21

Promoting interoperability

100

Improvement activities

40

Cost

76.12

Medicare fee-for-service enrollment

Enrolled in OH, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2026.

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1104124221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042101",
            "telephone_number": "309-664-3120",
            "fax_number": "309-663-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042101",
            "telephone_number": "309-664-3000",
            "fax_number": "309-664-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KERRI",
        "middle_name": "LYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-14",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.096519",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036177585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgibson530792@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3969 Salem Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454061529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3969 Salem Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454061529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Gibb, APN
• Gibson Community Hospital Association
• Gibson Community Hospital Association
• Gibson Community Hospital Association
• Julia Nicole Gibson
• Ashley Kate Giebelhausen
• Tara L Gilbert II, CADC
• David Gill, M.D.
• Molly R Gill, PT
• Stephanie Michele Gill, PMHNP

• All providers in Bloomington, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.