Active NPI
Jeffrey L Gibson DO PC
- Family Medicine Physician
- Nowata, OK
National Provider Identifier
1164555058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3261
- Legal business name
- JEFFREY L GIBSON DO PC
- Practice address
- 307A S Locust St
Nowata, OK 74048-3622 - Phone
- (918) 273-2761
- Fax
- (918) 273-2753
- NPI assigned
- Mar 13, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeffrey Gibson, DO
- Title
- Owner
- Phone
- (918) 273-2761
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3261 | OK | Primary |
Addresses
Primary practice location
307A S Locust St
Nowata, OK 74048-3622
Mailing address
307A S Locust St
Nowata, OK 74048-3622
Phone (918) 273-2761
Other names 1
- jeff gibson do
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
307A S Locust St
Nowata, OK 74048
Phone (918) 273-2761
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Nowata, OK
- NPI 1306807011
-
- Physician Assistant
- Tulsa, OK
- NPI 1265537757
-
- Physician Assistant
- Nowata, OK
- NPI 1023156791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1164555058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307A S LOCUST ST",
"city": "NOWATA",
"state": "OK",
"postal_code": "740483622",
"telephone_number": "918-273-2761",
"fax_number": "918-273-2753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307A S LOCUST ST",
"city": "NOWATA",
"state": "OK",
"postal_code": "740483622",
"telephone_number": "918-273-2761",
"fax_number": "918-273-2753"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEFFREY L GIBSON DO PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GIBSON",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-273-2761",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OK",
"license": "3261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "jeff gibson do",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Nowata, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.