Samuel S Gibson, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

M5763 Issued in ID

Practice address

6259 W Emerald St
Boise, ID 83704-8731

Phone

(208) 489-1900

Fax

(208) 375-5286

NPI assigned

Mar 3, 2006

Last updated

Sep 1, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Idaho Endoscopy Center LLC

  dba Nampa Idaho Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Nampa, ID
  • NPI 1043835713
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1275500738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048731",
            "telephone_number": "208-489-1900",
            "fax_number": "208-375-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048731",
            "telephone_number": "208-489-1900",
            "fax_number": "208-375-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M5763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003710000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Gibson, LCPC
• Lisa Jillian Gibson
• Michael P Gibson, MD
• Patricia Gibson
• Robb F Gibson, M.D.
• Virginia Gibson, CST
• Collin Giddings, DPT
• Megan Gierhart, PSY.D.
• Hayley Jo Giesler, OTA
• Sheila M Giffen, MD

• Gastroenterology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Gastroenterology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.