Active NPI
John Heyl Gibson, M.D.
- Neurology Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2006-00136
- Practice address
- 190 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6946 - Phone
- (336) 277-2200
- Fax
- (336) 277-2210
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Psychiatry & Neurology) Physician | 2084H0002X | 36445 | SC | |
| Neurology Physician | 2084N0400X | 36445 | SC | |
| Neurology Physician | 2084N0400X | 2006-00136 | NC | Primary |
Addresses
Primary practice location
190 Kimel Park Dr Ste 120
Winston Salem, NC 27103-6946
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 277-2200
Other practice location 1
171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00605571 | Other | NC | RR MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jgibson770184@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Wake Forest University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
152 E Kinderton Way
Suite 101
Bermuda Run, NC 27006-7351
Phone (336) 893-3180
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-00136 | NC | MD | Neurology Physician |
| 36445 | SC | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| The Regional Medical Center of Orangeburg and Calhoun Counties | Current | Accepting new patients | |
| The Regional Medical Center of Orangeburg and Calhoun Counties | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Regional Medical Center of Orangeburg and Calhoun Counties | Neurology | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Neurology | Current | Accepting new patients |
| University Medical Associates of the Medical University of South Carol | Neurology | Current | Accepting new patients |
| Novant Health Medical Group, LLC | Past | Accepting new patients | |
| Wake Forest University Health Sciences | Past | Accepting new patients |
Locations
152 E Kinderton Way
Ste 101
Bermuda Run, NC 27006
Phone (336) 893-3180
1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437
125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380
10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000
2290 Remount Rd
Gastonia, NC 28054
Phone (704) 316-4979
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
1219 Lexington Ave
Ste B
Thomasville, NC 27360
Phone (336) 475-0113
190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/0fba742b-eec1-4103-87e5-edbdf1fe1e30/
Organizations & group practices 10
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Hospitalist Physician
- Orangeburg, SC
- NPI 1003889676
-
- Multi-Specialty Clinic/Center
- Charleston, SC
- NPI 1043241110
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Neurology Physician
- Thomasville, NC
- NPI 1639642614
-
- Neurology Physician
- Orangeburg, SC
- NPI 1144940347
-
- Clinical Psychologist
- Orangeburg, SC
- NPI 1619387123
-
- Family Medicine Physician
- Charleston, SC
- NPI 1982678496
Neurology
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603584000000",
"number": "1326057928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "336-277-2200",
"fax_number": "336-277-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 KIMEL PARK DR STE 120",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036946",
"telephone_number": "336-277-2200",
"fax_number": "336-277-2210"
}
],
"practiceLocations": [
{
"address_1": "171 Ashley Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294258908",
"country_code": "US",
"telephone_number": "843-792-1414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "JOHN",
"middle_name": "HEYL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2020-10-25",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084H0002X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
"state": "SC",
"license": "36445",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "SC",
"license": "36445",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NC",
"license": "2006-00136",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00605571",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jgibson770184@direct.novanthealth.org",
"affiliation": "N",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294258908",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.
- 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.