Mikell Brynn Gibbons

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7181719 Issued in ID

Practice address

1550 Elk Creek Dr
Idaho Falls, ID 83404-8322

Phone

(208) 529-5942

Fax

(208) 529-5951

NPI assigned

May 18, 2026

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

Other names 1

• Mikell Brynn Weaver Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EIEEDD

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.

• Leavitt Womens Healthcare Corp,P.C.

  • Obstetrics & Gynecology Physician
  • Idaho Falls, ID
  • NPI 1972771756
  NPD (past)

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1285563841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-529-5942",
            "fax_number": "208-529-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-529-5942",
            "fax_number": "208-529-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "MIKELL",
        "middle_name": "BRYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "7181719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKELL",
            "last_name": "WEAVER",
            "middle_name": "BRYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeremy George, BS
• Paul A Gerlach, MD
• Darby Gibb
• Jennifer Ann Gibbard, MOTR/L
• Noah Gibbard
• Barrett J Gibson, DPT
• Jennaeve Gifford
• Mary Rebekah Gillespie
• Whitney Dianne Gillespie, LPC
• Fred Elmer Giovanini, L.D.

• Medical Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.