Individual provider Active NPI

Robert Blain Gibbons, MD

  • Anesthesiology Physician
  • Augusta, GA
National Provider Identifier
1144906827
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
15250 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-8623
NPI assigned
Jun 26, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 15250 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1120 15TH St # Bi2144
Augusta, GA 30912-0004
Phone (706) 721-3871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20230821001372 GA Order and Referring Only - AnesthesiologyPractitioner - Anesthesiology 5294197471

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Regent University PastSince Jul 2, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1144906827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # BI2144",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "ROBERT",
        "middle_name": "BLAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "15250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.