William Lee Gibson Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD.203335 Issued in LA

Practice address

1560 Irving PL
Shreveport, LA 71101-4604

Phone

(318) 212-1194

Fax

(318) 212-1196

NPI assigned

May 25, 2007

Last updated

Dec 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Family Practice

Education

Louisiana State University School of Medicine in Shreveport, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.gibson.1@22188.direct.athenahealth.com

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.

• DRG Medical LLC

  dba Gibson Family Practice

  • Addiction Medicine (Family Medicine) Physician
  • Shreveport, LA
  • NPI 1316418288
  Medicare reassignment NPD Authorized official
• Boyd Family Practice LLC

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1346389970
  NPD (past)
• Sharptime PT

  dba Trinity PT

  • Physical Therapy Clinic/Center
  • Bossier City, LA
  • NPI 1295516227
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Northern Louisiana

  dba Christus Shreveport-Bossier Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1205047578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014604",
            "telephone_number": "318-212-1194",
            "fax_number": "318-212-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014604",
            "telephone_number": "318-212-1194",
            "fax_number": "318-212-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WILLIAM",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.203335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50963",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice Gibson
• Chad Michael Gibson, MD
• Jenesis Raquel Gibson, LPC
• Kirk Gibson, MSN, RN, PCCN
• Shameka Gibson, MHS
• Prakash Giddaluri, MD, MPH
• Jimmy Lamar Giddings, LBSW
• Jerome P Gigante
• Peridot Gilbert, PLPC
• Kimberly Kay Gilbreath, RPH

• Family Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.