Cheryl A Gibson, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · South Burlington, VT
NPI 1124073317 · NPPES record last updated Mar 2, 2016
Key facts
- NPI
- 1124073317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 0420007465 (VT)
- Practice address
- 1775 Williston Rd Ste 110
South Burlington, VT 05403-6491 - Phone
- (877) 698-8496
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051017000080 | VT | Practitioner - Obstetrics/Gynecology | 3476597261 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420007465 | VT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vermont Gynecology, PC | Current |
Accepting new patients | |
| Planned Parenthood of Northern New England | Past | Accepting new patients |
Locations
1775 Williston Rd
Ste 110
South Burlington, VT 05403
Phone (800) 530-1140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 0420007465 | VT | Yes |
Addresses
Primary practice location
1775 Williston Rd Ste 110
South Burlington, VT 05403-6491
Mailing address
PO Box 250
Shelburne, VT 05482-0250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4000033 | Medicaid | VT |
Other providers in South Burlington, VT
- William T Gerson
- Get Healthy Vermont, PC
- Get Well Inc
- Emma Getty
- Nicol Giandomenico
- Matthew Philip Gilbert
- Kala Gillim
- Jennifer Plante Gilwee
- Gina Godek LLC
- Kadam Desai Giulianelli
All providers in South Burlington, VT · Obstetrics & Gynecology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.