Individual provider Active NPI

Emily Lynn Gibson, DO

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1114555737
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.016275 Issued in OH
Practice address
1244 Meadow Bridge Dr Ste 100
Beavercreek, OH 45434-6388
Phone
(937) 208-7600
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Family Medicine Physician 207Q00000X 34.016275 OH Primary

Addresses

Primary practice location

1244 Meadow Bridge Dr Ste 100
Beavercreek, OH 45434-6388

Mailing address

1244 Meadow Bridge Dr Ste 100
Beavercreek, OH 45434-6388
Phone (937) 208-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230810002389 OH Practitioner - Family Practice 1355762477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

1244 Meadow Bridge Dr
Suite 100
Beavercreek, OH 45434-6388
Phone (937) 208-7600

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.016275OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Single Specialty CurrentSince Sep 18, 2023 Accepting new patients
Mvhe Inc CurrentSince Sep 18, 2023 Accepting new patients
Mvhe Inc Past Accepting new patients
Lima Memorial Joint Operating Company Single Specialty Past Accepting new patients

Locations

1244 Meadow Bridge Dr
Ste 100
Beavercreek, OH 45434
Phone (937) 208-7600

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1114555737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 MEADOW BRIDGE DR STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346388",
            "telephone_number": "937-208-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 MEADOW BRIDGE DR STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346388",
            "telephone_number": "937-208-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "EMILY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.016275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.