NPIMap

Organization Active NPI

Gibson Community Hospital Association

Doing business as Gibson Area Family Medicine

  • Family Medicine Physician
  • Gibson City, IL
National Provider Identifier
1114304045
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0000836 Issued in IL
Legal business name
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Gibson Area Family Medicine
Practice address
201 E 8TH St
Gibson City, IL 60936-1422
Phone
(217) 784-4076
Fax
(217) 784-2044
NPI assigned
Apr 29, 2015
Last updated
Oct 8, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
GIBSON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Authorized official

Name
Mr. Mike Meunier, MBA, CHC
Title
Chief Compliance Officer
Phone
(217) 784-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0000836 IL Primary

Addresses

Primary practice location

201 E 8TH St
Gibson City, IL 60936-1422

Mailing address

201 E 8TH St
Gibson City, IL 60936-1422
Phone (217) 784-4076

Other names 1

  • Gibson Area Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505001293 IL Part B Supplier - Clinic/Group Practice 5092703124 Receives reassigned benefits from 201 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Watseka, IL; Urbana, IL; Paxton, IL; Fairbury, IL; Onarga, IL; Mahomet, IL; Hoopeston, IL; Gibson City, IL…

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Gibson Community Hospital43 organizations share this tax ID, including this one
Part of
Gibson Community Hospital

Other organizations with this tax ID 42

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

View all 42

Locations

201 E 8th St
Gibson City, IL 60936
Phone (217) 727-1088

650 E State St
Paxton, IL 60957
Phone (217) 379-0313

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1114304045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 8TH ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361422",
            "telephone_number": "217-784-4076",
            "fax_number": "217-784-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 8TH ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361422",
            "telephone_number": "217-784-4076",
            "fax_number": "217-784-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIBSON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "MEUNIER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "217-784-2286",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CHC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "0000836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson Area Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gibson City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.