Individual provider Active NPI

Craig Edward Gibson, DC

  • Chiropractor
  • Waynesville, NC
National Provider Identifier
1275620130
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1700 Issued in NC
Practice address
136 Waynesville Plaza
Ste 1
Waynesville, NC 28786
Phone
(828) 456-5700
Fax
(828) 456-5728
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1700 NC Primary

Addresses

Primary practice location

136 Waynesville Plaza
Ste 1
Waynesville, NC 28786

Mailing address

136 Waynesville Plaza
Ste 1
Waynesville, NC 28786
Phone (828) 456-5700

Other identifiers 1

IdentifierTypeStateIssuer
890882FMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001453 NC Practitioner - Chiropractic 6305828484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

136 Waynesville PLZ
Suite 1
Waynesville, NC 28786-2934
Phone (828) 456-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1700NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenscroft 58 Inc Chiropractor CurrentSince Dec 6, 2009 Accepting new patients
Outer Banks Medical Services Inc Chiropractor PastSince Feb 24, 2003 Accepting new patients

Locations

136 Waynesville Plz
Ste 116
Waynesville, NC 28786

136 Waynesville Plz
Waynesville, NC 28786

136 Waynesville Plz
Ste 1
Waynesville, NC 28786
Phone (828) 456-5700

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275620130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 WAYNESVILLE PLAZA",
            "address_2": "STE 1",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "28786",
            "telephone_number": "828-456-5700",
            "fax_number": "828-456-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 WAYNESVILLE PLAZA",
            "address_2": "STE 1",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "28786",
            "telephone_number": "828-456-5700",
            "fax_number": "828-456-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CRAIG",
        "middle_name": "EDWARD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890882F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.