Gwendolyn Octavia Gibson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101-057103 Issued in VA

Practice address

30 S Main St
Chatham, VA 24531-5436

Phone

(434) 432-4471

Fax

(434) 432-3555

NPI assigned

Aug 18, 2006

Last updated

May 12, 2026By the provider in NPPES

Sex

Female

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 VA

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

Specialty

Pediatric Medicine

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Piedmont Access to Health Services, Inc

  dba PATHS Community Medical Center Danville Riverside

  • Federally Qualified Health Center (FQHC)
  • Danville, VA
  • NPI 1114630662
  Medicare reassignment
• Piedmont Access to Health Services, Inc

  dba Health Centers of the Piedmont South Boston

  • Federally Qualified Health Center (FQHC)
  • South Boston, VA
  • NPI 1235677634
  Medicare reassignment
• Piedmont Access to Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Danville, VA
  • NPI 1649240698
  Medicare reassignment
• Richmond Pediatric Associates, Inc.

  • Pediatrics Physician
  • Richmond, VA
  • NPI 1689788390
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1265546055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411803",
            "telephone_number": "434-791-3630",
            "fax_number": "434-791-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S MAIN ST",
            "city": "CHATHAM",
            "state": "VA",
            "postal_code": "245315436",
            "telephone_number": "434-432-4471",
            "fax_number": "434-432-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "GWENDOLYN",
        "middle_name": "OCTAVIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101-057103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Friedrichs Family Eye Center PC (Friedrichs Family Eye Center Optometry)
• Antoineke Fuller, LPTA
• Maranda Vandyke Fuller, ED.S.
• Melinda Fulper, DDS
• Genix LLC
• Kevin Gilley, PHARMD
• Tangela Stephanie Hairston, FNP-BC
• Zachary Harrelson, PT, DPT
• Alesha Stone Harris
• Courtney Mustain Haskins, OTD

• Pediatrics Physician in Chatham, VA
• Providers in Chatham, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.