Michelle Bender Gibson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0017137534 Issued in VA

Practice address

2232 Wilborn Ave, Suite D
Hematology Oncology Practice of Southside VA, PC
South Boston, VA 24592-1662

Phone

(434) 575-1212

Fax

(434) 575-1130

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Duke University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dominion Health Medical AssocGroup PAC ID 1254311558, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Halifax Regional Hospital Hospital, South Boston, VA, CCN 490013

Merit-based Incentive Payment System (MIPS)

Final score

87.02 of 100Reported as group

Quality

66.66

Promoting interoperability

100

Improvement activities

40

Cost

90.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgibson524327@direct.sentara.net

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.

• Dominion Health Medical Assoc.

  • Ambulatory Surgical Clinic/Center
  • South Boston, VA
  • NPI 1255771770
  Medicare reassignment Care Compare group NPD
• Halifax Regional Hospital, Inc.

  • General Acute Care Hospital
  • South Boston, VA
  • NPI 1588668842
  Medicare reassignment NPD
• Dominion Health Medical Assoc

  • Cardiovascular Disease Physician
  • South Boston, VA
  • NPI 1356138879
  NPD
• Dominion Health Medical Assoc

  • Legal Medicine
  • South Boston, VA
  • NPI 1407051873
  NPD
• Halifax Regional Hospital, Inc

  • Rural Health Clinic/Center
  • South Boston, VA
  • NPI 1033728803
  NPD
• Dominion Health Medical Associates LTD

  • Non-Surgical Family Planning Clinic/Center
  • South Boston, VA
  • NPI 1992244172
  NPD (past)

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

• Halifax Regional Hospital, Inc.

  • General Acute Care Hospital
  • South Boston, VA
  • NPI 1588668842
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1124077136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 WILBORN AVE, SUITE D",
            "address_2": "HEMATOLOGY ONCOLOGY PRACTICE OF SOUTHSIDE VA, PC",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921662",
            "telephone_number": "434-575-1212",
            "fax_number": "434-575-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 WILBORN AVE, SUITE D",
            "address_2": "HEMATOLOGY ONCOLOGY PRACTICE OF SOUTHSIDE VA, PC",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921662",
            "telephone_number": "434-575-1212",
            "fax_number": "434-575-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MICHELLE",
        "middle_name": "BENDER",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0017137534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devmith Chinthaka Gajadeera, M.D.
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• Gerald C Burnett MD LTD
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• Judy Gourley
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• Raymond Allan Green, DDS

• Nurse Practitioner in South Boston, VA
• Providers in South Boston, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.