NPIMap

Individual provider Active NPI

Patrick John Gibbons, M.D.

  • Specialist
  • Midlothian, VA
National Provider Identifier
1336142124
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101229755 Issued in VA
Practice address
13700 St Francis Blvd
Suite 500
Midlothian, VA 23114-3222
Phone
(804) 378-7443
Fax
(804) 378-0744
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101229755 VA Primary

Addresses

Primary practice location

13700 St Francis Blvd
Suite 500
Midlothian, VA 23114-3222

Mailing address

PO Box 8310
Roanoke, VA 24014-0310
Phone (540) 345-3556

Other identifiers 1

IdentifierTypeStateIssuer
006501478MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061207000310 VA Practitioner - Otolaryngology 7719986462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Ear Nose and Throat Specialists PCGroup PAC ID 4284633934, 7 clinicians

Practice addresses (Care Compare)

1501 Maple Ave
Suite 205
Richmond, VA 23226-2553
Phone (804) 525-4231

Hospital & facility affiliations

  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101229755VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Hearing AIDS Inc CurrentSince Nov 1, 2006 Accepting new patients
Commonwealth Ear, Nose & Throat Specialists PC CurrentSince Aug 1, 2006 Accepting new patients
Roanoke Ear Nose & Throat Clinic Past Accepting new patients

Locations

13700 St Francis Blvd
Ste 500
Midlothian, VA 23114
Phone (804) 378-7443

1 Park West Cir
Ste 200
Midlothian, VA 23114
Phone (804) 378-7443

14051 St Francis Blvd
Ste 2211
Midlothian, VA 23114
Phone (804) 378-7443

1501 Maple Ave
Ste 205
Richmond, VA 23226
Phone (804) 525-4231

Organizations & group practices 3

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1336142124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240140310",
            "telephone_number": "540-345-3556",
            "fax_number": "540-342-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 ST FRANCIS BLVD",
            "address_2": "SUITE 500",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143222",
            "telephone_number": "804-378-7443",
            "fax_number": "804-378-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101229755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006501478",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.