Individual provider Active NPI

Jonathan Curtis Gibson, AGNP-C

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1245686161
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704232359 Issued in MI
Practice address
4100 Lake Dr SE
Grand Rapids, MI 49546-8292
Phone
(616) 267-7414
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704232359 MI Primary

Addresses

Primary practice location

4100 Lake Dr SE
Grand Rapids, MI 49546-8292

Mailing address

50 Industrial Park Rd
Bangor, MI 49013-1246
Phone (269) 427-7937

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Direct Messaging Address jgibson257776@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160624001599 MI Practitioner - Nurse Practitioner 6709177553 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

2009 Holton Rd
Muskegon, MI 49445-1578
Phone (231) 291-8399

4100 Lake Dr SE
Grand Rapids, MI 49546-8292

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Holland Hospital Hospital, Holland, MI, CCN 230072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704232359MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center of West Michigan CurrentSince Nov 1, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 1, 2023 Accepting new patients
Newaygo County General Hospital Association CurrentSince Dec 1, 2023 Accepting new patients
Intercare Community Health Network CurrentSince Jun 6, 2016 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Nov 1, 2024 Accepting new patients
Intercare Community Health Network CurrentSince Jun 6, 2016 Accepting new patients
Renal Associates of West Michigan PC CurrentSince Jun 13, 2016 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 1, 2023 Accepting new patients
Newaygo County General Hospital Association CurrentSince Dec 1, 2023 Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4100 Lake Dr SE
Grand Rapids, MI 49546
Phone (616) 267-7400

330 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 752-6235

285 James St
Holland, MI 49424
Phone (616) 399-0200

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

Interoperability endpoints

  • Direct secure messaging: jonathan.gibson@ichn.eclinicaldirectplus.com
  • Direct secure messaging: jgibson257776@epic00.corewelldirect.org

Organizations & group practices 9

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 5

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1245686161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK RD",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131246",
            "telephone_number": "269-427-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JONATHAN",
        "middle_name": "CURTIS",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704232359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "4100 Lake Dr SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgibson257776@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "4100 Lake Dr SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.