Individual provider Active NPI

Thomas J Gibson, MD

  • Surgery Physician
  • Winchester, VA
National Provider Identifier
1164417614
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101028329 Issued in VA
Practice address
20 S Stewart St
Suite 100
Winchester, VA 22601-4153
Phone
(540) 536-0130
Fax
(540) 536-0135
NPI assigned
Sep 12, 2005
Last updated
Feb 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101028329 VA Primary

Addresses

Primary practice location

20 S Stewart St
Suite 100
Winchester, VA 22601-4153

Mailing address

20 S Stewart St
Suite 100
Winchester, VA 22601-4153
Phone (540) 536-0130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101028329VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WSC LTD Surgery CurrentSince Jul 5, 1977 Accepting new patients
Valley Physician Enterprise, Inc. Past Accepting new patients
Valley Physician Enterprise Inc Past Accepting new patients

Locations

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

136 Linden Dr
Ste 104
Winchester, VA 22601

20 S Stewart St
Winchester, VA 22601
Phone (540) 536-0130

20 S Stewart St
Ste 100
Winchester, VA 22601
Phone (540) 536-0130

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1164417614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S STEWART ST",
            "address_2": "SUITE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014153",
            "telephone_number": "540-536-0130",
            "fax_number": "540-536-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S STEWART ST",
            "address_2": "SUITE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014153",
            "telephone_number": "540-536-0130",
            "fax_number": "540-536-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101028329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.