NPIMap

Individual provider Active NPI

Larry Gibson, MD

  • Neurology Physician
  • Hixson, TN
National Provider Identifier
1114013521
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD19747 Issued in TN
Practice address
2051 Hamill Rd
Ste 301 B
Hixson, TN 37343-6614
Phone
(423) 877-1212
NPI assigned
Oct 4, 2006
Last updated
Sep 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD19747 TN Primary

Addresses

Primary practice location

2051 Hamill Rd
Ste 301 B
Hixson, TN 37343-6614

Mailing address

2051 Hamill Rd Suite 302
Hixson, TN 37343
Phone (423) 877-1212

Other identifiers 2

IdentifierTypeStateIssuer
3181502MedicaidTN
3074845OtherTNBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000265 TN Practitioner - Neurology 5496774440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana Medical College, School of Medicine of Purdue University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northgate Neurology, PLLCGroup PAC ID 6901997535, 2 clinicians

Practice addresses (Care Compare)

2051 Hamill Rd
Hixson, TN 37343-4653
Phone (423) 877-1212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19747TNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northgate Neurology, PLLC CurrentSince Aug 20, 1997 Accepting new patients
Edward P Blochowiak Past Accepting new patients
NVMS of Kentucky LLC Past Accepting new patients

Locations

2051 Hamill Rd
Ste 301
Hixson, TN 37343
Phone (423) 870-3376

2051 Hamill Rd
Ste 302
Hixson, TN 37343
Phone (423) 877-1212

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: larrygibson@nnp-tn.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1114013521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 HAMILL RD SUITE 302",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "37343",
            "telephone_number": "423-877-1212",
            "fax_number": "423-877-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 HAMILL RD",
            "address_2": "STE 301 B",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373436614",
            "telephone_number": "423-877-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LARRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "MD19747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3181502",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "3074845",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.