Individual provider Active NPI

John Scott Gibson, MD

  • Internal Medicine Physician
  • McMinnville, OR
National Provider Identifier
1255433520
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14370 Issued in OR
Practice address
2375 NE Cumulus Ave
McMinnville, OR 97128-8861
Phone
(503) 472-0888
Fax
(503) 434-7246
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD14370 OR
Internal Medicine Physician 207R00000X MD14370 OR Primary

Addresses

Primary practice location

2375 NE Cumulus Ave
McMinnville, OR 97128-8861

Mailing address

PO Box 2
McMinnville, OR 97128-0002
Phone (503) 472-0888

Other identifiers 1

IdentifierTypeStateIssuer
141879MedicaidOR

Other names 1

  • J Scott Gibson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20040715000092 OR Practitioner - Internal Medicine 5991784894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2375 NE Cumulus Ave
McMinnville, OR 97128-8861
Phone (503) 472-0888

Hospital & facility affiliations

  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy189
Upper gastrointestinal (GI) endoscopy for acid reflux92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14370ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yamhill Valley Surgical Center Inc. CurrentSince Nov 1, 2009 Accepting new patients
J Scott Gibson MD PC Gastroenterology CurrentSince Jan 1, 1989 Accepting new patients

Locations

2375 NE Cumulus Ave
McMinnville, OR 97128
Phone (503) 472-0888

851 NE Baker St
Ste 3
McMinnville, OR 97128
Phone (503) 472-0888

2375 NE Cumulus Ave
Ste 1
McMinnville, OR 97128

Organizations & group practices 2

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 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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1255433520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971280002",
            "telephone_number": "503-472-0888",
            "fax_number": "503-434-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 NE CUMULUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288861",
            "telephone_number": "503-472-0888",
            "fax_number": "503-434-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JOHN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OR",
            "license": "MD14370",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD14370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141879",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "GIBSON",
            "middle_name": "SCOTT",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.