NPIMap

Individual provider Active NPI

Bryan Gibson

  • Emergency Medicine Physician
  • Murrells Inlet, SC
National Provider Identifier
1144517798
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301019288 Issued in MI
Practice address
4070 US Highway 17
Murrells Inlet, SC 29576
Phone
(843) 652-1167
Fax
(843) 520-8519
NPI assigned
Jul 5, 2011
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301019288 MI Primary

Addresses

Primary practice location

4070 US Highway 17
Murrells Inlet, SC 29576

Mailing address

4070 US 17
Murrells Inlet, SC 29576
Phone (843) 652-1167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150420001409 SC Practitioner - Emergency Medicine 6204067911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lincoln Memorial University Medical Department, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgetown Memorial HospitalGroup PAC ID 8224942123, 90 clinicians

Practice addresses (Care Compare)

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.46 of 100Reported as group
Quality
47.5
Promoting interoperability
100
Improvement activities
40
Cost
83.42

Merit-based Incentive Payment System (MIPS)

Final score
88.55 of 100Reported as group
Quality
85
Promoting interoperability
100
Improvement activities
40
Cost
76.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301019288MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Memorial Hospital CurrentSince Jan 31, 2015 Accepting new patients
Waccamaw Community Hospital CurrentSince Jan 31, 2015 Accepting new patients
Georgetown Memorial Hospital CurrentSince Jan 31, 2015 Accepting new patients

Locations

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

Interoperability endpoints

  • Direct secure messaging: bgibson447763@direct.musc.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1144517798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 US 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-652-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 US HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-652-1167",
            "fax_number": "843-520-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301019288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.