Kevin Patrick Gibbs, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

34753 Issued in SC

Practice address

1519 Marion St
Columbia, SC 29201-2910

Phone

(803) 296-5954

NPI assigned

Jun 13, 2012

Last updated

Nov 13, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prisma Health University Medical Group

  dba Department of Radiology

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1568799955
  Medicare reassignment NPD
• Prisma Health Imaging Centers, LLC

  dba Prisma Health Imaging Center Sunset

  • Physiological Laboratory
  • West Columbia, SC
  • NPI 1518710912
  NPD

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1316209513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 MARION ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012910",
            "telephone_number": "803-296-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL34753",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "34753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jai-Inder Ghotra, DMD
• Amanda Gibbons, RRT
• Michael Thomas Gibbons, MD
• Ashley Michelle Gibbs-Sanders, APRN
• Calvin Gibbs
• Mariea Gibbs, LMT, CMMP
• Mykenzi Gibbs, PA-C
• Timothy Gibbs
• Bailey Erin Gibson
• Emily Williams Gibson, M.S.W., L.S.W.

• Diagnostic Radiology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Diagnostic Radiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.