Individual provider Active NPI

Mary Elizabeth Gibson, M.D.

  • Orthopaedic Hand Surgery Physician
  • Tupelo, MS
National Provider Identifier
1205216579
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
U5702 Issued in TX
Practice address
499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751
Phone
(662) 377-2663
NPI assigned
Jun 2, 2015
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Orthopaedic Surgery Physician 207X00000X TRN21705 FL
Orthopaedic Surgery Physician 207X00000X 28979 MS
Orthopaedic Hand Surgery Physician 207XS0106X 28979 MS
Orthopaedic Hand Surgery Physician 207XS0106X U5702 TX Primary

Addresses

Primary practice location

499 Gloster Creek VLG Ste G1
Tupelo, MS 38801-4751

Mailing address

499 S Gloster St # G1
Tupelo, MS 38801-5539
Phone (662) 377-2663

Other practice location 1

MSC10 5600 University of New Meixco
Department of Orthopaedics
Albuquerque, NM 87131-0001
Phone (505) 272-4107

Other practice location 2

8715 Village Dr Ste 120
San Antonio, TX 78217-5425
Phone (210) 477-5151

Other practice location 3

1222 S Orange Ave
5th Floor
Orlando, FL 32806-1215
Phone (321) 841-1764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210810000293 MS Practitioner - Orthopedic Surgery 0749593424 Reassigns benefits to 1 organization
I20230920001298 TX Practitioner - Orthopedic Surgery 0749593424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Medical School at Houston, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

8715 Village Dr
Suite 120
San Antonio, TX 78217-5425
Phone (210) 477-5151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN21705FLMDOrthopaedic Surgery Physician
28979MSMDOrthopaedic Hand Surgery Physician
U5702TXMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Institute of North Mississippi, LLC CurrentSince Oct 1, 2023 Accepting new patients
BHS Physicians Network, Inc Multi-Specialty CurrentSince Sep 7, 2023 Accepting new patients
BHS Physicians Network, Inc CurrentSince Sep 7, 2023 Accepting new patients
Orthopaedic Institute of North Mississippi, LLC Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients
BHS Specialty Network Inc Multi-Specialty Past Accepting new patients

Locations

499 Gloster Creek Vlg
Ste G1
Tupelo, MS 38801
Phone (662) 377-2663

499 S Gloster St
#G1
Tupelo, MS 38801
Phone (662) 377-2663

6704 Randolph Blvd
Live Oak, TX 78233
Phone (210) 656-9506

2648 Loop 337
New Braunfels, TX 78130
Phone (830) 310-3203

18707 Hardy Oak Blvd
Ste 415
San Antonio, TX 78258
Phone 2104775151 ext. 108

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

8715 Village Dr
Ste 120
San Antonio, TX 78217
Phone (210) 653-5001

17766 Verde Pkwy
Ste 150
Selma, TX 78154

Interoperability endpoints

  • Direct secure messaging: mary.gibson.1@1438.direct.athenahealth.com

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 1

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1205216579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 S GLOSTER ST # G1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015539",
            "telephone_number": "662-377-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE G1",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014751",
            "telephone_number": "662-377-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MSC10 5600 University of New Meixco",
            "address_2": "Department of Orthopaedics",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-4107",
            "fax_number": "505-272-8098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8715 Village Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782175425",
            "country_code": "US",
            "telephone_number": "210-477-5151",
            "fax_number": "210-477-5152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1222 S Orange Ave",
            "address_2": "5th Floor",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061215",
            "country_code": "US",
            "telephone_number": "321-841-1764",
            "fax_number": "321-841-1870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "TRN21705",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "28979",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MS",
            "license": "28979",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "TX",
            "license": "U5702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.