Jennifer M. Gibson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

37913 Issued in IA

Practice address

3449 N Anchor St Ste 300a
Portland, OR 97217-7679

Phone

(503) 283-0013

Fax

(503) 283-0785

NPI assigned

Mar 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Internal Medicine

  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Internal Medicine

  Medicare reassignment NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455

  Internal Medicine

  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027
  NPD

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1144299900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 N ANCHOR ST STE 300A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177679",
            "telephone_number": "503-283-0013",
            "fax_number": "503-283-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 N ANCHOR ST STE 300A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177679",
            "telephone_number": "503-283-0013",
            "fax_number": "503-283-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IA",
            "license": "37913",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "37913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144299900",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAID",
            "identifier": "1144299900",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "1144299900",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Gibson
• Anna Gibson
• Colleen Fridl Gibson, L.AC.
• Jacob Ryan Gibson
• Jennifer Anne Gibson
• Larissa Gibson
• Lindsey Erin Gibson, MED
• Lisa Camille Gibson, RN BSN
• Madeline Jane Gibson
• Margaret Gibson, OTD, OTR/L

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.