Individual provider Active NPI

Ronald C Gibson, M.D.

  • Internal Medicine Physician
  • Coldwater, MI
National Provider Identifier
1154498525
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
RG052179 Issued in MI
Practice address
360 E Chicago St
Suite 110
Coldwater, MI 49036-2086
Phone
(517) 278-7331
Fax
(517) 278-9917
NPI assigned
Nov 29, 2006
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X RG052179 MI Primary

Addresses

Primary practice location

360 E Chicago St
Suite 110
Coldwater, MI 49036-2086

Mailing address

360 E Chicago St
Suite 110
Coldwater, MI 49036-2086
Phone (517) 278-7331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20101021000090 MI Practitioner - Internal Medicine 6103019252 Reassigns benefits to 2 organizations
Practice locations: Coldwater, MI

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

360 E Chicago St
Suite 110
Coldwater, MI 49036-2086
Phone (517) 278-7331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RG052179MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Branch County Internal Medicine CurrentSince Aug 8, 2022 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Regio T Penna MD, PC Current Accepting new patients
Community Health Center of Branch County Past Accepting new patients

Locations

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

360 E Chicago St
Ste 110
Coldwater, MI 49036
Phone (517) 278-7331

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJBDA/Endpoint/CAJBDA

Organizations & group practices 5

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1154498525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E CHICAGO ST",
            "address_2": "SUITE 110",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362086",
            "telephone_number": "517-278-7331",
            "fax_number": "517-278-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E CHICAGO ST",
            "address_2": "SUITE 110",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362086",
            "telephone_number": "517-278-7331",
            "fax_number": "517-278-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RONALD",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "RG052179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.