NPIMap

Individual provider Active NPI

George Gibson, M.D

  • Interventional Cardiology Physician
  • Pueblo, CO
National Provider Identifier
1205880960
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
32323 Issued in CO
Practice address
3670 Parker Blvd Ste 101
Pueblo, CO 81008-2207
Phone
(719) 564-1544
Fax
(719) 924-1593
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 32323 CO
Interventional Cardiology Physician 207RI0011X 32323 CO Primary

Addresses

Primary practice location

3670 Parker Blvd Ste 101
Pueblo, CO 81008-2207

Mailing address

3670 Parker Blvd Ste 101
Pueblo, CO 81008-2207
Phone (719) 562-2900

Other practice location 1

1000 Rush Dr
Salida, CO 81201-9627
Phone (719) 530-2000

Other identifiers 2

IdentifierTypeStateIssuer
P00997269OtherCORAILROAD MEDICARE
01323237MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cardiology@HRRMCMedicalClinics.ssdirect.aprima.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000247 CO Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Orthopedic Surgery 9830382274 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Hahnemann University College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285
Phone (719) 562-2900

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32323COMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Salida Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Salida Hospital District CurrentSince Jul 1, 2019 Accepting new patients
Salida Hospital District CurrentSince Jul 1, 2019 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

3670 Parker Blvd
Pueblo, CO 81008
Phone (719) 562-2900

1600 N Grand Ave
Ste 500B
Pueblo, CO 81003
Phone (719) 562-2900

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

3670 Parker Blvd
Ste 101
Pueblo, CO 81008
Phone (719) 562-2900

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

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 and National Provider Directory roles.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1205880960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD STE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082207",
            "telephone_number": "719-562-2900",
            "fax_number": "719-924-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD STE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082207",
            "telephone_number": "719-564-1544",
            "fax_number": "719-924-1593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Rush Dr",
            "address_purpose": "LOCATION",
            "city": "Salida",
            "state": "CO",
            "postal_code": "812019627",
            "country_code": "US",
            "telephone_number": "719-530-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "GEORGE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "32323",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "32323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00997269",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01323237",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cardiology@HRRMCMedicalClinics.ssdirect.aprima.com",
            "affiliation": "N",
            "address_1": "1000 Rush Dr",
            "city": "Salida",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812019627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.