Larry Gibson, M.D., P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

LARRY GIBSON, M.D., P.C.

Practice address

2051 Hamill Road
#B
Hixson, TN 37343

Phone

(423) 877-1212

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Larry Gibson, M.D.

Title

Owner/President

Phone

(423) 954-9556

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346333895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 VALLEY FORGE DRIVE",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "37343",
            "telephone_number": "423-954-9556",
            "fax_number": "423-954-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 HAMILL ROAD",
            "address_2": "#B",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "37343",
            "telephone_number": "423-877-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY GIBSON, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "423-954-9556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3181502",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "3074845",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prabha A Kunda, M.D.
• Nicole A Lacey
• Jennifer Lake, LMT
• Kimberly Michelle Lancaster, ATC
• Roger Lynn Land, M.D.
• Laurie McGee PT, DPT, PCS
• Lynn R Lavook, DC
• Stewart Lawwill III, DDS
• Michael Allen Leazer, DPH
• Kimberly Dawn Ledbetter, PTA

• Neurology Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.