Harold Gibson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001587 Issued in MI

Practice address

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Phone

(734) 712-3456

NPI assigned

Jun 28, 2006

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• South Huron Urgent Care Center PLC

  • Urgent Care Clinic/Center
  • Ypsilanti, MI
  • NPI 1376853291
  Medicare reassignment

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1265469746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "HAROLD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "001587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Simonne Ghant, MD
• Wissam Ghozayel, PHARM D.
• Anastasia Gibbs, LPC
• Jeffrey Gibbs, MD
• Shonda Gibbs
• Latrice D Gibson
• Serena ER Gibson
• Tremaine Gibson, LMT
• Eric John Gieske
• Mark Giesler, PHD, LMSW

• Physician Assistant in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.