Merlyn D Gibson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

DR.0024218 Issued in CO

Practice address

1765 Tiverton Ave
Broomfield, CO 80023-9310

Phone

(952) 595-1100

Fax

(612) 294-4903

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ton San Xavier Health Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tucson, AZ
  • NPI 1518905793
  NPD (past)
• Ton Sells Hospital

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Sells, AZ
  • NPI 1699717785
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1124044565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "address_2": "STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 TIVERTON AVE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239310",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MERLYN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "21787",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0024218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Gervers
• Shelby Ghazaleh
• Sarah Ann Ghekiere, ND, LAC
• Matthew Christopher Gibble, RMT
• Jamie Gibbs, MA, LPC
• Kimberly Gieck, PHARM D
• Gilead Health LLC
• Dean Giles
• Brandi Gillen
• M'Lynn Gilliam

• Diagnostic Radiology Physician in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Diagnostic Radiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.